Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03975 | Date 21/03/2023 |
| Token No | SM/22-23/17465 15/01/2024 | Serial | 002 |
| Patient Name | Mrs. UMA DEY | Contact No | 8697877036 |
| Address | 65/5/12 PRAVASHNAGAR SERAMPORE 712249 | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||