Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03414 | Date 18/11/2019 |
| Token No | SM/19-20/7784 29/11/2019 | Serial | 047 |
| Patient Name | Mr. DIPANKAR DEBNATH | Contact No | 8697358578 |
| Address | 26 AKHRA BATI | Age | 25 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||