Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03689 | Date 06/01/2020 |
| Token No | SM/19-20/8330 10/01/2020 | Serial | 008 |
| Patient Name | Mrs. GURIA SHAW | Contact No | 9007681460 |
| Address | 2 NO LALIT MOHON BHATTACHARYA STREET | Age | 32 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||