Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03100 | Date 09/11/2022 |
| Token No | SM/22-23/4297 11/11/2022 | Serial | 010 |
| Patient Name | Mr. RANJAN DAS | Contact No | 7044131175 |
| Address | 37Q JANNAGAR ROAD SOUTH SERAMPORE 712201 | Age | 36 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||