Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03416 | Date 18/11/2019 |
| Token No | SM/18-19/7557 20/11/2019 | Serial | 014 |
| Patient Name | Mrs. SWAPNA DEY | Contact No | 8697402297 |
| Address | 25D/1 DEY STREET | Age | 60 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||