Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00762 | Date 18/01/2020 |
| Token No | SM/19-20/1727 22/01/2020 | Serial | 007 |
| Patient Name | Mrs. JAYA DAS | Contact No | 9231531833 |
| Address | PROVASNAGER | Age | 52 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||