Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03019 | Date 09/09/2019 |
| Token No | SM/18-19/6425 13/09/2019 | Serial | 029 |
| Patient Name | Mrs. MAYA DEBI | Contact No | 9836365285 |
| Address | 82 DEY STREET | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||