Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03465 | Date 22/11/2019 |
| Token No | SM/22-23/5961 02/11/2022 | Serial | 002 |
| Patient Name | Mr. ADITYA DEY SARKAR | Contact No | 9903862381 |
| Address | 73 DEY STREET | Age | 19 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||