Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00605 | Date 23/12/2019 |
| Token No | SM/19-20/1581 14/01/2020 | Serial | 015 |
| Patient Name | Mr. DEENA ROUTH | Contact No | 7449445839 |
| Address | 43/A/1 PRABASHNAGAR PURBAPARA SERAMPORE 712249 | Age | 46 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||