Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03694 | Date 07/01/2020 |
| Token No | SM/19-20/8332 10/01/2020 | Serial | 010 |
| Patient Name | Mrs. MAMATA DAS | Contact No | 8337082611 |
| Address | 121/B PATUA PARA LANE | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||