Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04570 | Date 22/07/2023 |
| Token No | SM/25-26/12577 31/12/2025 | Serial | 024 |
| Patient Name | Mrs. PAYEL DAS | Contact No | 8910141852 |
| Address | PRAVASNAGAR SERAMPORE 712249 | Age | 17 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||