Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01063 | Date 24/02/2020 |
| Token No | SM/19-20/2623 26/02/2020 | Serial | 028 |
| Patient Name | Mrs. KALPANA ROY | Contact No | 8017679499 |
| Address | 3 HARIPARA 2ND LANE SERAMPORE 712203 | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||