Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02367 | Date 27/06/2019 |
| Token No | SM/18-19/4532 28/06/2019 | Serial | 022 |
| Patient Name | Mr. NABA KUMAR DEY | Contact No | NOT GIVEN |
| Address | THAKUR BATI STREET | Age | 42 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||