Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03087 | Date 21/09/2019 |
| Token No | SM/18-19/6589 21/09/2019 | Serial | 008 |
| Patient Name | Mrs. SOMA CHAKRABORTY | Contact No | 9874357735 |
| Address | 30 PANCHANAN TALA LANE | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||