Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03621 | Date 16/12/2019 |
| Token No | SM/19-20/8124 18/12/2019 | Serial | 009 |
| Patient Name | Mr. TAPAN CHAKRABORTY | Contact No | 9830829746 |
| Address | NAGARMORE, GHOSAL PARA | Age | 54 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||