Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 02691 | Date 13/09/2022 |
| Token No | SM/22-23/2720 14/09/2022 | Serial | 012 |
| Patient Name | Mr. KALACHAND BANERJEE | Contact No | 9748768022 |
| Address | 326 G T ROAD SERAMPORE MAHESH 712203 | Age | 56 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||