Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00621 | Date 28/12/2019 |
| Token No | SM/19-20/1341 31/12/2019 | Serial | 024 |
| Patient Name | Mrs. KRISHNA DUTTA | Contact No | 8296277262 |
| Address | 155/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||