Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01042 | Date 22/02/2020 |
| Token No | SM/19-20/2528 24/02/2020 | Serial | 033 |
| Patient Name | Mr. SHIKATA BAIDHAY | Contact No | |
| Address | TALPUKUR SERAMPORE | Age | 52 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||