Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02811 | Date 16/08/2019 |
| Token No | SM/18-19/5813 21/08/2019 | Serial | 030 |
| Patient Name | Mr. TANMOY SARKAR | Contact No | 8478965221 |
| Address | 17 KAILASH CHATTERJEE LANE | Age | 34 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||