Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03942 | Date 20/03/2020 |
| Token No | SM/19-20/8731 20/03/2020 | Serial | 005 |
| Patient Name | Mr. SANJAY KUMAR DUTTA | Contact No | NOT GIVEN |
| Address | 3/A BROJO DUTTA LANE | Age | 57 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||