Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00487 | Date 20/08/2018 |
| Token No | SM/18-19/6637 23/09/2019 | Serial | 039 |
| Patient Name | Mrs. MOUSUMI CHATTERJEE | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||