Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02910 | Date 27/08/2019 |
| Token No | SM/18-19/6007 29/08/2019 | Serial | 005 |
| Patient Name | Mr. TIMIR RANJAN DEY | Contact No | 9804028776 |
| Address | 8D DEY STREET | Age | 66 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||