Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03819 | Date 23/02/2023 |
| Token No | SM/22-23/7775 24/03/2023 | Serial | 003 |
| Patient Name | Mrs. SARITA SHAW | Contact No | 9875692321 |
| Address | 65/19/6 GURU GARDEN ROAD SERAMPORE M 712249 | Age | 35 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||