Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03888 | Date 06/03/2023 |
| Token No | SM/25-26/4470 08/07/2025 | Serial | 002 |
| Patient Name | Mrs. SHUKLA CHAKRABORTY | Contact No | 9903738570 |
| Address | 65/25B MAHESH JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||