Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00281 | Date 22/10/2019 |
| Token No | SM/19-20/1724 22/01/2020 | Serial | 004 |
| Patient Name | Mrs. RUPA SAHA | Contact No | 9143385685 |
| Address | BIBIRBER SERAMPORE | Age | 45 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||