Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00847 | Date 03/02/2020 |
| Token No | SM/19-20/2095 07/02/2020 | Serial | 060 |
| Patient Name | Mrs. SUSMITA PAL | Contact No | |
| Address | 22/B FIRINGI DANGA ROAD SERAMPORE 712203 | Age | 29 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||