Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04476 | Date 14/06/2021 |
| Token No | SM/21-22/406 14/06/2021 | Serial | 004 |
| Patient Name | Mr. MALOY CHATTERJEE | Contact No | 9163317381 |
| Address | NALIKUL | Age | 77 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||