Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02968 | Date 01/09/2019 |
| Token No | SM/18-19/6192 03/09/2019 | Serial | 039 |
| Patient Name | Mrs. PUJA SAHANA | Contact No | 8348922540 |
| Address | SERAMPORE | Age | 19 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||