Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04153 | Date 15/03/2021 |
| Token No | SM/20-21/9149 15/03/2021 | Serial | 001 |
| Patient Name | Mr. PRADIP KUMAR BHAR | Contact No | 9836978814 |
| Address | 12D CHATTERJEE LANE | Age | 62 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||