Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03032 | Date 02/11/2022 |
| Token No | SM/22-23/4594 21/11/2022 | Serial | 002 |
| Patient Name | Mrs. DOLLY ROY | Contact No | 8697613975 |
| Address | 55 NO ROYLAND ROAD SERAMPORE 712201 | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||