Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02434 | Date 08/07/2019 |
| Token No | SM/18-19/4717 09/07/2019 | Serial | 033 |
| Patient Name | Mr. LALU SHA | Contact No | NOT GIVEN |
| Address | SERAMPORE TIN BAZAR | Age | 58 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||