Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02477 | Date 17/08/2022 |
| Token No | SM/22-23/2093 17/08/2022 | Serial | 037 |
| Patient Name | Miss BAISHNAVI KUMARI | Contact No | 8583990484 |
| Address | 43/27/S/A GURU GARDEN ROAD SERAMPORE 712249 | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||