Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00706 | Date 10/01/2020 |
| Token No | SM/22-23/8339 24/04/2023 | Serial | 006 |
| Patient Name | Mrs. TUMPA SHIULI | Contact No | 9163191753 |
| Address | 3-D B B GHOSH ROAD SERAMPORE 712203 | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||