Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02312 | Date 18/06/2019 |
| Token No | SM/18-19/4283 18/06/2019 | Serial | 002 |
| Patient Name | Mr. RAJIB DUTTA | Contact No | 9874943789 |
| Address | BROJO DUTTA LANE | Age | 47 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||