Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04168 | Date 12/05/2023 |
| Token No | SM/22-23/8764 12/05/2023 | Serial | 011 |
| Patient Name | Mrs. JYOTI DEVI | Contact No | 7003972282 |
| Address | 9/433 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||