Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04045 | Date 24/09/2020 |
| Token No | SM/19-20/8966 28/09/2020 | Serial | 016 |
| Patient Name | Mrs. SUNANDA DAS | Contact No | 7439553058 |
| Address | INDIA JUTE MILL | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||