Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09657 | Date 28/07/2025 |
| Token No | SM/25-26/5514 29/07/2025 | Serial | 012 |
| Patient Name | Mrs. JAYANTI CHOWDHURY | Contact No | 7980746385 |
| Address | 125 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||