Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01636 | Date 23/05/2022 |
| Token No | SM/22-23/201 28/05/2022 | Serial | 005 |
| Patient Name | Miss SUMONA DUTTA | Contact No | 9073542256 |
| Address | 43/47 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||