Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03511 | Date 29/11/2019 |
| Token No | SM/19-20/7776 29/11/2019 | Serial | 039 |
| Patient Name | Mr. SHYAMAL KUMAR MUKHERJEE | Contact No | |
| Address | Age | 63 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||