Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01234 | Date 19/03/2020 |
| Token No | SM/19-20/3297 20/03/2020 | Serial | 015 |
| Patient Name | Mr. RABINDRANATH SANNYAL | Contact No | |
| Address | PRABASHNAGAR SERAMPORE 712249 | Age | 50 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||