Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02126 | Date 04/07/2022 |
| Token No | SM/22-23/1097 05/07/2022 | Serial | 002 |
| Patient Name | Mrs. RIMPA DAS | Contact No | 7679339979 |
| Address | 43/46/C GURU GARDEN ROAD SERAMPORE PRABASHNAGAR 712249 | Age | 18 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||