Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03731 | Date 13/01/2020 |
| Token No | SM/19-20/8980 01/10/2020 | Serial | 005 |
| Patient Name | Mrs. SANGITA NAYAK | Contact No | 8479960258 |
| Address | BAT TALA SERAMPORE | Age | 23 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||