Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 05786 | Date 04/12/2023 |
| Token No | SM/22-23/16116 04/12/2023 | Serial | 006 |
| Patient Name | Mrs. JUHI AMARNATH PATWA | Contact No | 8013630941 |
| Address | 107/A/1 GURUGARDEN ROAD SERAMPORE 712249 | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||