Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01130 | Date 05/03/2020 |
| Token No | SM/19-20/2901 06/03/2020 | Serial | 049 |
| Patient Name | Mr. TAPAS DAS | Contact No | 9883665354 |
| Address | SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 44 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||