Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03280 | Date 29/11/2022 |
| Token No | SM/22-23/4870 30/11/2022 | Serial | 005 |
| Patient Name | Mrs. KRISHNA DAS | Contact No | 9062385609 |
| Address | 65/25/23 MAHESH JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||