Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03401 | Date 16/11/2019 |
| Token No | SM/18-19/7487 18/11/2019 | Serial | 029 |
| Patient Name | Mr. SHYAMAL KUMAR CHATTERJEE | Contact No | 8697358395 |
| Address | 4 NO RUDRA RAM PANDIT LANE | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||