Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01527 | Date 30/04/2020 |
| Token No | SM/22-23/3446 14/10/2022 | Serial | 015 |
| Patient Name | Mrs. GITA DEVI | Contact No | 8478092499 |
| Address | 97/P/8 GURU GARDEN ROAD SERAMPORE PRABASHNAGAR 712249 | Age | 43 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||