Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02920 | Date 28/08/2019 |
| Token No | SM/18-19/6437 14/09/2019 | Serial | 001 |
| Patient Name | Mrs. MAYA MUKHERJEE | Contact No | NOT GIVEN |
| Address | PANCHANAN TALA LANE | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||