Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03341 | Date 07/12/2022 |
| Token No | SM/25-26/20639 27/08/2026 | Serial | 004 |
| Patient Name | Mrs. SRISTI RAM | Contact No | 8013660677 |
| Address | 65/25/1/1 MAHESH JANNAGAR ROAD SERAMPORE 712249 | Age | 17 Years,2 Months,27 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||