Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00680 | Date 07/01/2020 |
| Token No | SM/25-26/12570 31/12/2025 | Serial | 017 |
| Patient Name | Mrs. USHA SINGH | Contact No | 7044765580 |
| Address | BANGIHATI MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 119/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||