Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03154 | Date 01/10/2019 |
| Token No | SM/19-20/8398 16/01/2020 | Serial | 001 |
| Patient Name | Mrs. JAYANTI CHOWDHURY | Contact No | NOT GIVEN |
| Address | MANIKTALA | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||