Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03596 | Date 11/01/2023 |
| Token No | SM/22-23/6044 11/01/2023 | Serial | 003 |
| Patient Name | Mrs. NIYATI CHAKRABORTY | Contact No | 8100608143 |
| Address | 30/72 TARAPUKUR LANE SERAMPORE 712203 | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||