Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02717 | Date 05/08/2019 |
| Token No | SM/18-19/5547 08/08/2019 | Serial | 034 |
| Patient Name | Miss ANWESHA CHAKRABORTY | Contact No | 9330495492 |
| Address | 142 THAKUR BATI STREET | Age | 14 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||