Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 03612 | Date 14/12/2019 |
| Token No | SM/19-20/8099 16/12/2019 | Serial | 030 |
| Patient Name | Mr. LALON PARBAT | Contact No | 8585020021 |
| Address | 18 T.P. BHATTACHARYA ST | Age | 62 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||