Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01923 | Date 16/04/2019 |
| Token No | SM/18-19/7440 15/11/2019 | Serial | 039 |
| Patient Name | Mr. SK BINOD | Contact No | 8017727336 |
| Address | N L BHATTACHARYA STREET | Age | 48 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||