Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01133 | Date 06/03/2020 |
| Token No | SM/19-20/2930 07/03/2020 | Serial | 028 |
| Patient Name | Mr. RABINDRANATH DAS | Contact No | 9674782058 |
| Address | 55A/3 JANNAGAR ROAD WEST PRABASHNAGAR SERAMPORE 712203 | Age | 65 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||