Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00966 | Date 15/02/2020 |
| Token No | SM/19-20/2279 15/02/2020 | Serial | 013 |
| Patient Name | Mrs. SUDIPA DEY | Contact No | 9143335524 |
| Address | 118 G T ROAD PRABASHNAGAR SERAMPORE | Age | 20 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||