Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02164 | Date 06/07/2022 |
| Token No | SM/22-23/1190 07/07/2022 | Serial | 012 |
| Patient Name | Mrs. GIRIJA DEVI | Contact No | 8420012384 |
| Address | 107/E2 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||