Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00025 | Date 03/08/2018 |
| Token No | SM/21-22/1317 27/10/2021 | Serial | 019 |
| Patient Name | Mrs. ARATI DAS | Contact No | NOT GIVEN |
| Address | BAT TALA | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||