Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02700 | Date 02/08/2019 |
| Token No | SM/18-19/5483 06/08/2019 | Serial | 062 |
| Patient Name | Mrs. SUTAPA DEY | Contact No | 744707424 |
| Address | JANAI KRISHNARAMPUR | Age | 68 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||