Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03144 | Date 30/09/2019 |
| Token No | SM/21-22/1422 18/11/2021 | Serial | 007 |
| Patient Name | Mrs. RITA DEVI | Contact No | 7003674235 |
| Address | 2 GOPAL GANGULY LANE | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||