Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03647 | Date 26/12/2019 |
| Token No | SM/19-20/8155 27/12/2019 | Serial | 001 |
| Patient Name | Mrs. TAPATI MUKHERJEE | Contact No | 8240464039 |
| Address | 47 PANCHANAN TALA LANE(KOKIL BAGAN) | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||