Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00790 | Date 22/01/2020 |
| Token No | SM/19-20/1883 28/01/2020 | Serial | 038 |
| Patient Name | Mrs. SANTANA DAS | Contact No | 9831633614 |
| Address | 43/16/3 PRABASHNAGAR SERAMPORE 712249 | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||