Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01089 | Date 27/02/2020 |
| Token No | SM/19-20/2716 29/02/2020 | Serial | 005 |
| Patient Name | Mrs. ARATI DAS | Contact No | 8013327589 |
| Address | 34/B/39 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 75 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||