Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00929 | Date 12/02/2020 |
| Token No | SM/19-20/2269 15/02/2020 | Serial | 003 |
| Patient Name | Mrs. RAJKUMARI DEBI | Contact No | |
| Address | 80/2 KHATIR BAZAR LANE SERAMPORE 712202 | Age | 55 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||