Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01665 | Date 25/05/2022 |
| Token No | SM/22-23/3910 01/11/2022 | Serial | 007 |
| Patient Name | Mr. GOPAL CHAKRABORTY | Contact No | 8603591524 |
| Address | GHORAMARA P PURBAPARA SERAMPORE 712203 | Age | 77 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||