Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01913 | Date 11/04/2019 |
| Token No | SM/18-19/5068 23/07/2019 | Serial | 035 |
| Patient Name | Mr. SANJOY SADHUKHAN | Contact No | 9123305118 |
| Address | 117 R.B. SARANI | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||