Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00734 | Date 14/01/2020 |
| Token No | SM/19-20/1585 14/01/2020 | Serial | 019 |
| Patient Name | Mrs. SNIGDHA DAS PATRA | Contact No | 9433910466 |
| Address | 11E PRABASHNAGAR SERAMPORE 712249 | Age | 32 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||