Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00240 | Date 24/09/2019 |
| Token No | SM/19-20/2837 05/03/2020 | Serial | 021 |
| Patient Name | Mrs. RAMA DUTTA | Contact No | 7596955737 |
| Address | 65/7/9 MAHESH JANNAGAR ROAD PROVASNAGER SERAMPORE 712249 | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||