Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01022 | Date 19/02/2020 |
| Token No | SM/19-20/2498 24/02/2020 | Serial | 003 |
| Patient Name | Mrs. ANIMA ROY | Contact No | 9330149150 |
| Address | 190 RAJYADHARPUR GOV COLONY SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||