Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00425 | Date 30/08/2018 |
| Token No | SM/18-19/6743 27/09/2019 | Serial | 017 |
| Patient Name | Mrs. PADMA PRADHAN | Contact No | 8420311476 |
| Address | DEY STREET | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||