Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02668 | Date 30/07/2019 |
| Token No | SM/18-19/5374 03/08/2019 | Serial | 001 |
| Patient Name | Mrs. JAYA DUTTA | Contact No | 9433327193 |
| Address | 7 DHARMATALA LANE | Age | 53 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||