Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02975 | Date 03/09/2019 |
| Token No | SM/18-19/6255 06/09/2019 | Serial | 003 |
| Patient Name | Mr. ANANTA APPAT | Contact No | 9062843716 |
| Address | 44 B DR NANILAL BHATTACHARYA STRRET | Age | 40 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||