Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02583 | Date 23/07/2019 |
| Token No | SM/18-19/6090 30/08/2019 | Serial | 073 |
| Patient Name | Mr. PRANAB CHATTERJEE | Contact No | NOT GIVEN |
| Address | 28/A K.B.LANE | Age | 75 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||