Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03355 | Date 11/11/2019 |
| Token No | SM/18-19/7609 21/11/2019 | Serial | 030 |
| Patient Name | Mrs. BASANTI CHATTERJEE | Contact No | 8910907556 |
| Address | 10 CHATTERJEE LANE | Age | 59 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||