Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03287 | Date 30/11/2022 |
| Token No | SM/22-23/4867 30/11/2022 | Serial | 002 |
| Patient Name | Mr. SEKH SURAB | Contact No | 9163922491 |
| Address | 81 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 35 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||