Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04360 | Date 21/06/2023 |
| Token No | SM/22-23/9766 21/06/2023 | Serial | 014 |
| Patient Name | Mr. RABIN SEN | Contact No | 7278070562 |
| Address | 65/25/11A M.J ROAD SERAMPORE M 712249 | Age | 52 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||