Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03108 | Date 23/09/2019 |
| Token No | SM/18-19/6730 27/09/2019 | Serial | 004 |
| Patient Name | Mr. KANAI NANDI | Contact No | 8420827496 |
| Address | 4A PITAMBAR DEY LANE | Age | 70 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||