Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04074 | Date 15/10/2020 |
| Token No | SM/19-20/9013 15/10/2020 | Serial | 007 |
| Patient Name | Mrs. BULBUL DEY | Contact No | |
| Address | DEY STREET | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||