Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07197 | Date 28/06/2024 |
| Token No | SM/25-26/4188 01/07/2025 | Serial | 003 |
| Patient Name | Mrs. CHAMPA DAS | Contact No | 8013156326 |
| Address | 80 RISHI BANKIM SARANI SERAMPORE 712201 | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||