Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01612 | Date 01/02/2019 |
| Token No | SM/18-19/5073 23/07/2019 | Serial | 040 |
| Patient Name | Mrs. RADHA BISWAL | Contact No | 9163852466 |
| Address | 52 N L BHATTACHARJEE STREET | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||