Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00647 | Date 03/01/2020 |
| Token No | SM/19-20/2128 08/02/2020 | Serial | 029 |
| Patient Name | Mr. NARAYAN CHANDRA DAS | Contact No | 9088484798 |
| Address | 171 2 NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||