Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01025 | Date 20/02/2020 |
| Token No | SM/19-20/2588 25/02/2020 | Serial | 030 |
| Patient Name | Mrs. SHILA DEBNATH | Contact No | 9143150550 |
| Address | 34 B/24 B B GHOSH ROAD SUKANTA PALLY 712203 | Age | 57 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||