Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02136 | Date 04/07/2022 |
| Token No | SM/22-23/2514 06/09/2022 | Serial | 013 |
| Patient Name | Mr. SANJAY DAS | Contact No | 9088352753 |
| Address | 49/D GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 45 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||