Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02892 | Date 26/08/2019 |
| Token No | SM/22-23/5090 13/09/2022 | Serial | 016 |
| Patient Name | Mrs. MALATI DAS | Contact No | 9477402585 |
| Address | 60 dey street | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||