Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00773 | Date 21/01/2020 |
| Token No | SM/19-20/1788 24/01/2020 | Serial | 027 |
| Patient Name | Mr. JAIDEEP SIL | Contact No | 9143064981 |
| Address | PROVASNAGER | Age | 9 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||