Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00876 | Date 06/02/2020 |
| Token No | SM/19-20/2033 06/02/2020 | Serial | 006 |
| Patient Name | Mr. DILIP DAS | Contact No | 6289538584 |
| Address | 72/A/5 PRABASHNAGAR SERAMPORE 712249 | Age | 62 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||