Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01929 | Date 16/06/2022 |
| Token No | SM/22-23/590 16/06/2022 | Serial | 004 |
| Patient Name | Mr. MANASA GAYEN | Contact No | 9681276434 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 49 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||