Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02282 | Date 17/06/2019 |
| Token No | SM/18-19/5760 20/08/2019 | Serial | 028 |
| Patient Name | Mrs. REKHA GHOSH | Contact No | 9433406653 |
| Address | DEY STREET, SOHINI APPARTMENT, SERAMPORE | Age | 73 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||