Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01680 | Date 15/02/2019 |
| Token No | SM/19-20/8943 25/09/2020 | Serial | 005 |
| Patient Name | Mrs. NAMITA KUNDU | Contact No | 9748461778 |
| Address | 33 PANDIT KALINATH BHATTACHARYA STREET | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||