Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02108 | Date 30/06/2022 |
| Token No | SM/22-23/1301 14/07/2022 | Serial | 001 |
| Patient Name | Mr. DIPANKAR DEBNATH | Contact No | 7044174005 |
| Address | 15/E DINEN BHATTACHARYA SARANI PRABASHNAGAR SERAMPORE 712249 | Age | 35 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||