Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01273 | Date 02/11/2018 |
| Token No | SM/19-20/8051 14/12/2019 | Serial | 006 |
| Patient Name | Mr. SALIL KR BANERJEE | Contact No | 26528814 |
| Address | 5C PITAMBAR DEY LANE | Age | 79 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||