Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00381 | Date 15/11/2019 |
| Token No | SM/19-20/3234 18/03/2020 | Serial | 036 |
| Patient Name | Mrs. INDRA DEVI GUPTA | Contact No | 8420981281 |
| Address | 97/Y PRABASHNAGAR SERAMPORE 712249 | Age | 69 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||