Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00136 | Date 16/09/2019 |
| Token No | SM/22-23/19310 02/03/2024 | Serial | 005 |
| Patient Name | Mrs. ANNAPURNA MAJUMDER | Contact No | 9804666609 |
| Address | 5 NO SERAMPORE COLONY MALLICKPARA 712203 | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||