Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03652 | Date 02/01/2020 |
| Token No | SM/19-20/8203 03/01/2020 | Serial | 001 |
| Patient Name | Mrs. UMA MAKAL | Contact No | 9874450522 |
| Address | 8 BROJO DUTTA LANE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||