Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00620 | Date 28/12/2019 |
| Token No | SM/19-20/1340 31/12/2019 | Serial | 023 |
| Patient Name | Mr. BHOLA DEY | Contact No | 9874269926 |
| Address | 119 GURUGARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 53 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||