Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02866 | Date 21/08/2019 |
| Token No | SM/18-19/6004 29/08/2019 | Serial | 002 |
| Patient Name | Mr. GOBINDA RAY | Contact No | 9679480054 |
| Address | 13 KAILASH CHATTERJEE LANE | Age | 47 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||