Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03936 | Date 15/03/2023 |
| Token No | SM/22-23/7558 15/03/2023 | Serial | 005 |
| Patient Name | Mr. SONU SHAW | Contact No | 8100663181 |
| Address | 66/B/1 GURUGARDEN ROAD SERAMPORE 712249 | Age | 12 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||