Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04021 | Date 14/09/2020 |
| Token No | SM/20-21/9191 23/03/2021 | Serial | 006 |
| Patient Name | Mr. BHOLANATH DEY | Contact No | NOT GIVEN |
| Address | A B GARDEN LANE | Age | 82 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||