Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02642 | Date 29/07/2019 |
| Token No | SM/21-22/1930 18/01/2022 | Serial | 010 |
| Patient Name | Mrs. REKHA DEY | Contact No | 9007065803 |
| Address | 4A DEY STREET | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||