Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09282 | Date 14/05/2025 |
| Token No | SM/25-26/2018 14/05/2025 | Serial | 065 |
| Patient Name | Mrs. SREYOSHI SHOW | Contact No | 7998409190 |
| Address | 10 BOSE PARA LANE SERAMPORE 712202 | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||