Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02821 | Date 16/08/2019 |
| Token No | SM/18-19/5672 16/08/2019 | Serial | 040 |
| Patient Name | Mrs. PUJA VERMA | Contact No | |
| Address | SERAMPORE | Age | 26 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||