Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04115 | Date 04/12/2020 |
| Token No | SM/21-22/295 19/05/2021 | Serial | 017 |
| Patient Name | Mr. PRANAB CHATTERJEE | Contact No | |
| Address | NALIKUL | Age | 58 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||