Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01341 | Date 03/04/2020 |
| Token No | SM/19-20/4106 06/07/2020 | Serial | 005 |
| Patient Name | Mrs. RINA DAS | Contact No | 9016112729 |
| Address | 245/A 2 NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 49 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||