Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01581 | Date 07/07/2020 |
| Token No | SM/19-20/4114 07/07/2020 | Serial | 006 |
| Patient Name | Mr. OM PRAKASH SHAW | Contact No | 8820546205 |
| Address | 166 NEW MAHESH SERAMPORE 712203 | Age | 53 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||