Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00458 | Date 26/11/2019 |
| Token No | SM/25-26/10603 18/11/2025 | Serial | 002 |
| Patient Name | Mrs. PRAMILA DEVI SHAW | Contact No | 9163960053 |
| Address | GHORAMARA P SERAMPORE 712203 | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 110/60 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||