Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07631 | Date 14/11/2022 |
| Token No | SM/22-23/6415 16/11/2022 | Serial | 045 |
| Patient Name | Mr. SAMRAT DEY | Contact No | 7686003486 |
| Address | 64/A THAKURBATI STREET | Age | 12 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||