Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01858 | Date 04/04/2019 |
| Token No | SM/18-19/5075 23/07/2019 | Serial | 042 |
| Patient Name | Mr. ADHOR MAITY | Contact No | 7278209404 |
| Address | 48 KHASBAGAN LANE | Age | 75 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||