Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00218 | Date 23/09/2019 |
| Token No | SM/19-20/2127 08/02/2020 | Serial | 028 |
| Patient Name | Mrs. SONI GUPTA | Contact No | 6289038656 |
| Address | RISHRA PRAVASHNAGAR SERAMPORE 712249 | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||