Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02225 | Date 14/07/2022 |
| Token No | SM/22-23/3834 29/10/2022 | Serial | 008 |
| Patient Name | Mr. SUKANTA MALAKAR | Contact No | 8479048188 |
| Address | 34/B/27 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 36 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||