Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03620 | Date 16/12/2019 |
| Token No | SM/19-20/8122 18/12/2019 | Serial | 007 |
| Patient Name | Mrs. DIPALI DEBNATH | Contact No | 9331645358 |
| Address | 47G BHAGIRATHI LANE | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||