Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10434 | Date 20/12/2021 |
| Token No | SM/21-22/7952 21/12/2021 | Serial | 008 Last Visit: 21/12/2021 |
| Patient Name | Mr. DIBAKAR DUTTA | Contact No | |
| Address | 67/A CHATRA BARUI PARA LANE | Age | 66 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||