Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02986 | Date 26/10/2022 |
| Token No | SM/22-23/3778 26/10/2022 | Serial | 001 |
| Patient Name | Mrs. KAVITA UPADDHAYAY SUKHLA | Contact No | 7980973605 |
| Address | 161 MAHESH JAN NAGAR ROAD PRAVASNAGAR SERAMPORE 712249 | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||