Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01166 | Date 13/03/2020 |
| Token No | SM/19-20/3085 14/03/2020 | Serial | 022 |
| Patient Name | Mrs. RANI KANTI | Contact No | 9007783095 |
| Address | 9/A TARAPUKUR QUARTER SERAMPORE 712203 | Age | 10 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||