Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03574 | Date 09/12/2019 |
| Token No | SM/19-20/8480 25/01/2020 | Serial | 007 |
| Patient Name | Mrs. SARITA PRAMANICK | Contact No | 7047979690 |
| Address | RAMCHANDRA PUR, BALI | Age | 32 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||