Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00333 | Date 05/11/2019 |
| Token No | SM/19-20/2582 25/02/2020 | Serial | 024 |
| Patient Name | Mrs. GITA DAS | Contact No | 9674426033 |
| Address | 188/2/A SERAMPORE MALLICKPARA | Age | 72 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||