Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03653 | Date 02/01/2020 |
| Token No | SM/19-20/8206 03/01/2020 | Serial | 004 |
| Patient Name | Mrs. ASHOKA MUKHERJEE | Contact No | NOT GIVEN |
| Address | 13 CHATTERJEE LANE | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||