Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01114 | Date 02/03/2020 |
| Token No | SM/19-20/2838 05/03/2020 | Serial | 022 |
| Patient Name | Mrs. KALPANA CHOWDHURY | Contact No | 7003110445 |
| Address | 35C TARAPUKUR LANE SERAMPORE 712203 | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||