Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01026 | Date 20/02/2020 |
| Token No | SM/19-20/2506 24/02/2020 | Serial | 011 |
| Patient Name | Mr. GOUTAM ROY | Contact No | |
| Address | 35A TARAPUKUR LANE SERAMPORE 712203 | Age | 62 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||