Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03560 | Date 06/12/2019 |
| Token No | SM/19-20/9067 02/12/2020 | Serial | 002 |
| Patient Name | Mr. GOUTAM NANDI | Contact No | 6291374488 |
| Address | 5/A L M BHATTACHARJEE STREET | Age | 54 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||