Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09504 | Date 26/06/2025 |
| Token No | SM/25-26/4065 28/06/2025 | Serial | 001 |
| Patient Name | Mrs. RUPA GUPTA | Contact No | 9875354935 |
| Address | 65/19/6 GURUGARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 43 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||