Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01964 | Date 23/04/2019 |
| Token No | SM/18-19/5812 21/08/2019 | Serial | 029 |
| Patient Name | Mr. ASHOK DUTTA | Contact No | 9163193107 |
| Address | 646 G T ROAD | Age | 63 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||