Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04651 | Date 28/07/2023 |
| Token No | SM/22-23/11095 28/07/2023 | Serial | 027 |
| Patient Name | Mrs. SUMALI MUKHERJEE | Contact No | 9831663114 |
| Address | 13 SIDDESHWARI LANE SERAMPORE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||