Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02806 | Date 14/08/2019 |
| Token No | SM/18-19/5717 19/08/2019 | Serial | 025 |
| Patient Name | Mrs. SHYAMALI BHAR | Contact No | 9836978814 |
| Address | 12D CHATTERJEE LANE | Age | 57 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||