Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01728 | Date 28/02/2019 |
| Token No | SM/18-19/2664 01/03/2019 | Serial | 023 |
| Patient Name | Mr. TAPAS BANERJEE | Contact No | 7278649721 |
| Address | 52 PANCHANAN TALA LANE | Age | 61 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||