Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00611 | Date 24/12/2019 |
| Token No | SM/19-20/1729 22/01/2020 | Serial | 009 |
| Patient Name | Mrs. ARATI DAS | Contact No | 9088133736 |
| Address | 65/25/19 PRABASHNAGAR SERAMPORE 712249 | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||