Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04160 | Date 11/05/2023 |
| Token No | SM/22-23/10713 20/07/2023 | Serial | 004 |
| Patient Name | Mr. FULCHAND SAH | Contact No | 9123638355 |
| Address | 10/B HARIPARA LANE SERAMPORE 712203 | Age | 35 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||