Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00757 | Date 18/01/2020 |
| Token No | SM/24-25/27217 27/08/2024 | Serial | 006 |
| Patient Name | Miss RISHA DAS | Contact No | 9681931876 |
| Address | 34/B/47 SUKANTA PALLY SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||