Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01231 | Date 30/10/2018 |
| Token No | SM/18-19/7558 20/11/2019 | Serial | 015 |
| Patient Name | Mr. DEEPAK SAH | Contact No | 7762892001 |
| Address | 14 J.N LAHIRI ROAD SERAMPORE | Age | 23 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||