Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02530 | Date 22/08/2022 |
| Token No | SM/22-23/2214 22/08/2022 | Serial | 068 |
| Patient Name | Mr. USUF BISWAS | Contact No | |
| Address | PROVASNAGAR SERAMPORE 712249 | Age | 16 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||