Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03584 | Date 09/12/2019 |
| Token No | SM/19-20/8059 14/12/2019 | Serial | 014 |
| Patient Name | Mrs. RADHIKA DEBI | Contact No | 9038411780 |
| Address | 13 DEY GHAT LANE | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||