Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03608 | Date 13/12/2019 |
| Token No | SM/19-20/8133 19/12/2019 | Serial | 001 |
| Patient Name | Mrs. NAMITA BHATTACHARYA | Contact No | 9836730023 |
| Address | 87 DEY STREET | Age | 71 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||