Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00451 | Date 25/11/2019 |
| Token No | SM/19-20/2207 13/02/2020 | Serial | 011 |
| Patient Name | Mrs. MINTA DEBI | Contact No | 7278736479 |
| Address | 3/A DR AMBEDKAR LANE MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||