Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01599 | Date 22/01/2019 |
| Token No | SM/19-20/8959 28/09/2020 | Serial | 009 |
| Patient Name | Mrs. SANDHYA PAKIRA | Contact No | 7890241129 |
| Address | CHOWDHURY PARA | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||