Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00634 | Date 31/12/2019 |
| Token No | SM/22-23/3307 10/10/2022 | Serial | 018 |
| Patient Name | Mr. TARAK DAS | Contact No | 8017835395 |
| Address | 50 G T ROAD WEST JHILBAGAN SERAMPORE 712203 | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||