Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01899 | Date 09/04/2019 |
| Token No | SM/19-20/8119 18/12/2019 | Serial | 004 |
| Patient Name | Mrs. MANJU DASGUPTA | Contact No | 9836730418 |
| Address | 57/12/B RAILAND ROAD | Age | 65 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||