Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00913 | Date 10/02/2020 |
| Token No | SM/19-20/2968 11/03/2020 | Serial | 022 |
| Patient Name | Mr. BHOLANATH CHAKRABORTY | Contact No | 8017789968 |
| Address | 76 N C CHAKRABORTY LANE BAIDYABATI 712204 | Age | 73 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||