Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02603 | Date 02/09/2022 |
| Token No | SM/22-23/6178 20/01/2023 | Serial | 001 |
| Patient Name | Mr. KHOKAN BANIK | Contact No | 8013863542 |
| Address | 24 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 43 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||