Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 06916 | Date 01/06/2024 |
| Token No | SM/24-25/22628 03/06/2024 | Serial | 004 |
| Patient Name | Mrs. SHIVAKI RAJAK | Contact No | 7003986889 |
| Address | 66/D/4 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||