Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00075 | Date 11/09/2019 |
| Token No | SM/19-20/2647 27/02/2020 | Serial | 022 |
| Patient Name | Mr. HIRALAL RAM | Contact No | 8013510473 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 74 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||