Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02125 | Date 27/05/2019 |
| Token No | SM/18-19/3825 27/05/2019 | Serial | 028 |
| Patient Name | Mr. SANJOY CHATTERJEE | Contact No | 9830740326 |
| Address | NALIKUL | Age | 69 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||