Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03014 | Date 09/09/2019 |
| Token No | SM/18-19/6348 11/09/2019 | Serial | 018 |
| Patient Name | Mr. SAYAN BASU | Contact No | 9830842418 |
| Address | 7 DEY BAGAN LANE | Age | 17 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||