Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02358 | Date 27/06/2019 |
| Token No | SM/18-19/5384 03/08/2019 | Serial | 011 |
| Patient Name | Mrs. ILA KUNDU | Contact No | 8013338153 |
| Address | 34 K M SHA STREET | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||