Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01578 | Date 06/07/2020 |
| Token No | SM/19-20/4108 06/07/2020 | Serial | 007 |
| Patient Name | Mrs. KIRAN DEVI SINGH | Contact No | 6289926202 |
| Address | D-1/303 SUBASH NAGAR HOUSING PRAVASHNAGAR SERAMPORE 712249 | Age | 57 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||