Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00812 | Date 27/01/2020 |
| Token No | SM/19-20/2021 05/02/2020 | Serial | 028 |
| Patient Name | Mrs. NANKI DEBI | Contact No | |
| Address | 10A/E BARAL BAGAN LANE SERAMPORE 712201 | Age | 60 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||