Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02847 | Date 20/08/2019 |
| Token No | SM/18-19/5860 24/08/2019 | Serial | 001 |
| Patient Name | Mr. GOUTAM BANERJEE | Contact No | 9433542304 |
| Address | 16 CHATTERJEE LANE | Age | 65 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||