Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02100 | Date 30/06/2022 |
| Token No | SM/22-23/1085 04/07/2022 | Serial | 052 |
| Patient Name | Mrs. RATNA DUTTAGUPTA | Contact No | 8910666140 |
| Address | C/121/X C BLOCK TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 43 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||