Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01621 | Date 23/05/2022 |
| Token No | SM/22-23/854 25/06/2022 | Serial | 003 |
| Patient Name | Mr. RANJAN ROUTH | Contact No | 7595054131 |
| Address | 9/433 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 57 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||