Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02640 | Date 29/07/2019 |
| Token No | SM/18-19/5278 30/07/2019 | Serial | 043 |
| Patient Name | Mrs. SHRABANI DEY. | Contact No | 9804028776 |
| Address | 8/B DEY STREET | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||