Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00570 | Date 18/12/2019 |
| Token No | SM/22-23/355 03/06/2022 | Serial | 024 |
| Patient Name | Mrs. SUSHILA DEVI | Contact No | 9007455457 |
| Address | 65/A/8 MAHESH JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||