Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02788 | Date 26/09/2022 |
| Token No | SM/22-23/3100 27/09/2022 | Serial | 002 |
| Patient Name | Mr. AJIT NANDI | Contact No | |
| Address | TARAPUKUR GOVT COLONY SERAMPORE 712203 | Age | 78 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||