Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02378 | Date 02/08/2022 |
| Token No | SM/22-23/4937 02/12/2022 | Serial | 005 |
| Patient Name | Mr. JIBAN KUMAR RAKSHIT | Contact No | 7278473155 |
| Address | 43/16/D GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||