Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03522 | Date 02/12/2019 |
| Token No | SM/19-20/7892 06/12/2019 | Serial | 006 |
| Patient Name | Mr. TAPAN DEY | Contact No | 9339217214 |
| Address | 62 DEY ST | Age | 75 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||