Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 06109 | Date 29/01/2024 |
| Token No | SM/22-23/18271 07/02/2024 | Serial | 008 |
| Patient Name | Mrs. MOUSUMI PRAMANICK | Contact No | 8777835176 |
| Address | 65/28 F D ROAD 2NO COLONY MALLICKPARA SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||