Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01236 | Date 30/10/2018 |
| Token No | SM/19-20/8399 16/01/2020 | Serial | 002 |
| Patient Name | Mrs. KUMARI PRADHAN | Contact No | NOT GIVEN |
| Address | SERAMPORE COLLEGE | Age | 53 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||