Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04394 | Date 30/06/2023 |
| Token No | SM/22-23/10062 03/07/2023 | Serial | 005 |
| Patient Name | Mr. RATAN DAS | Contact No | 9674306826 |
| Address | GHORAMARA P PURBAPARA SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||