Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04086 | Date 25/04/2023 |
| Token No | SM/22-23/8378 25/04/2023 | Serial | 004 |
| Patient Name | Mrs. JABA DAS | Contact No | 9163639759 |
| Address | 43/18/1 PROVASNAGAR SERAMPORE 712249 | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||