Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05769 | Date 28/04/2022 |
| Token No | SM/22-23/2884 05/05/2022 | Serial | 023 |
| Patient Name | Mr. ASHOK KUMAR SAHA | Contact No | 8981857207 |
| Address | SERAMPORE BAT TALA | Age | 45 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||