Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04527 | Date 18/07/2023 |
| Token No | SM/22-23/14723 26/10/2023 | Serial | 002 |
| Patient Name | Mr. SANDIP LAL RABIDAS | Contact No | 7890380097 |
| Address | PURBAPARA GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||