Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01692 | Date 26/05/2022 |
| Token No | SM/22-23/139 26/05/2022 | Serial | 003 |
| Patient Name | Miss SUSHMA RAJBHAR | Contact No | 7980072723 |
| Address | 117 NEW MAHESH SERAMPORE 712203 | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||