Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09745 | Date 13/08/2025 |
| Token No | SM/25-26/6370 14/08/2025 | Serial | 029 |
| Patient Name | Mrs. MAMATA PRIYADARSHINI SWAIN | Contact No | 7751827154 |
| Address | 107 PRAVASHNAGAR G G ROAD SERAMPORE 712249 | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||