Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03445 | Date 20/11/2019 |
| Token No | SM/19-20/8274 07/01/2020 | Serial | 005 |
| Patient Name | Mrs. CHANDRA BANERJEE | Contact No | 7003847774 |
| Address | 5/A PITAMBAR DEY LANE | Age | 63 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||