Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04158 | Date 11/05/2023 |
| Token No | SM/22-23/8715 11/05/2023 | Serial | 001 |
| Patient Name | Mr. BISWAJIT CHAKRABORTY | Contact No | 9007806760 |
| Address | 30/75 TARAPUKUR LANE MALLICKPARA SERAMPORE 7122203 | Age | 71 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||