Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03545 | Date 05/12/2019 |
| Token No | SM/19-20/7954 09/12/2019 | Serial | 027 |
| Patient Name | Mr. MAINAK DHAR | Contact No | 8910720543 |
| Address | 111/B J N LAHIRI ROAD | Age | 11 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||