Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01569 | Date 04/07/2020 |
| Token No | SM/19-20/4097 04/07/2020 | Serial | 005 |
| Patient Name | Mrs. SUJATA GHOSH | Contact No | 8240198362 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||