Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03055 | Date 04/11/2022 |
| Token No | SM/25-26/12501 30/12/2025 | Serial | 004 |
| Patient Name | Mrs. PURNIMA GAYEN | Contact No | 9883606635 |
| Address | 13/54 B B GHOSH ROAD SERAMPORE 712203 | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 110/80 mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||