Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02258 | Date 18/07/2022 |
| Token No | SM/22-23/1977 11/08/2022 | Serial | 014 |
| Patient Name | Mrs. SUJATA SAMANTA | Contact No | 8481002476 |
| Address | 65/1 WEST JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||