Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03384 | Date 15/11/2019 |
| Token No | SM/18-19/7497 18/11/2019 | Serial | 039 |
| Patient Name | Mr. AVINASH KUMAR DAS | Contact No | 9903756714 |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 16 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||