Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02458 | Date 11/07/2019 |
| Token No | SM/19-20/8965 28/09/2020 | Serial | 015 |
| Patient Name | Mr. PRADIPTA DAS | Contact No | NOT GIVEN |
| Address | LALIT MOHON BHATTACHARYA STREET | Age | 75 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||