Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01572 | Date 04/07/2020 |
| Token No | SM/19-20/4101 04/07/2020 | Serial | 009 |
| Patient Name | Mrs. CHHAYA TARAFDAR | Contact No | 9903611944 |
| Address | 65/25/25/A WEST JANNAGAR ROAD PRABASHNAGAR SERAMPORE HOOGHLY 712249 | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||