Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03489 | Date 28/11/2019 |
| Token No | SM/19-20/7783 29/11/2019 | Serial | 046 |
| Patient Name | Mrs. SUDESHNA SENGUPTA | Contact No | 7003323711 |
| Address | 5/B DEY STREET | Age | 27 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||