Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04865 | Date 01/09/2021 |
| Token No | SM/21-22/1188 27/09/2021 | Serial | 025 |
| Patient Name | Mr. TARUN BANERJEE | Contact No | NOT GIVEN |
| Address | POTUA PARA | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||