Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01028 | Date 20/02/2020 |
| Token No | SM/19-20/2590 25/02/2020 | Serial | 032 |
| Patient Name | Mr. SAMIR PAL | Contact No | 9143899995 |
| Address | GHORAMARA MALLICKPARA 712203 | Age | 40 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||