Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03546 | Date 05/12/2019 |
| Token No | SM/19-20/7956 09/12/2019 | Serial | 029 |
| Patient Name | Mrs. TAPU DHAR PAL | Contact No | 8910720543 |
| Address | 11/B J N LAHIRI ROAD | Age | 42 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||