Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02786 | Date 26/09/2022 |
| Token No | SM/22-23/3103 27/09/2022 | Serial | 005 |
| Patient Name | Mr. GOPINATH GHOSH | Contact No | 7890279434 |
| Address | 65/2 PRABASHNAGAR SERAMPORE 712249 | Age | 65 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||