Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 02944 | Date 30/08/2019 |
| Token No | SM/18-19/6478 16/09/2019 | Serial | 038 |
| Patient Name | Mrs. SANJU DEBI | Contact No | 8100185982 |
| Address | 14 J N LAHIRI ROAD | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||