Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00155 | Date 16/09/2019 |
| Token No | SM/22-23/955 29/06/2022 | Serial | 005 |
| Patient Name | Mrs. REBA CHATTERJEE | Contact No | 9836655140 |
| Address | 65/3/B CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||