Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00619 | Date 28/12/2019 |
| Token No | SM/19-20/2622 26/02/2020 | Serial | 027 |
| Patient Name | Mrs. NIVA RANI DEY | Contact No | 9748269926 |
| Address | 119 GURU GARDEN ROAD PRABASHNAGAR 712249 | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||