Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02625 | Date 26/07/2019 |
| Token No | SM/18-19/5809 21/08/2019 | Serial | 026 |
| Patient Name | Mr. SAILEN SRIMANI | Contact No | 8697854498 |
| Address | K C BHATTACHARJEE STREET | Age | 70 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||