Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02235 | Date 15/07/2022 |
| Token No | SM/22-23/1394 18/07/2022 | Serial | 017 |
| Patient Name | Mrs. FALGUNI CHAKRABORTY | Contact No | 7998312050 |
| Address | 30/72 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||