Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00146 | Date 16/09/2019 |
| Token No | SM/19-20/3194 17/03/2020 | Serial | 042 |
| Patient Name | Mrs. MANJU DEVI SINGH | Contact No | 7439377096 |
| Address | 13 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||