Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01922 | Date 14/06/2022 |
| Token No | SM/22-23/3961 02/11/2022 | Serial | 012 |
| Patient Name | Mrs. MOUMITA CHAKRABORTY | Contact No | 6290545058 |
| Address | 34/B/60 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||