Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03554 | Date 05/12/2019 |
| Token No | SM/19-20/7963 09/12/2019 | Serial | 036 |
| Patient Name | Mr. MRITYUNJOY DAS | Contact No | 9836165833 |
| Address | SERAMPORE | Age | 48 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||