Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00201 | Date 20/09/2019 |
| Token No | SM/19-20/1722 22/01/2020 | Serial | 002 |
| Patient Name | Mrs. SANKARI ROY | Contact No | 7890739497 |
| Address | 30/37 TARAPUKUR LANE,SERAMPORE 712203 | Age | 66 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||