Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02709 | Date 02/08/2019 |
| Token No | SM/18-19/5475 06/08/2019 | Serial | 054 |
| Patient Name | Mr. RAJA ADHIKARY | Contact No | |
| Address | SRERAMPORE PITAMBAR DEY LANE | Age | 34 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||