Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01077 | Date 26/02/2020 |
| Token No | SM/19-20/2715 29/02/2020 | Serial | 004 |
| Patient Name | Mrs. MINA SHARMA | Contact No | 7890284127 |
| Address | 34/B/11 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||