Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01944 | Date 22/04/2019 |
| Token No | SM/24-25/18950 23/09/2024 | Serial | 029 |
| Patient Name | Mr. SARBARI DEY | Contact No | 9339622532 |
| Address | 92B DEY STREET | Age | 83 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||