Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09775 | Date 19/08/2025 |
| Token No | SM/25-26/6551 19/08/2025 | Serial | 010 |
| Patient Name | Mrs. TUMPA DAM | Contact No | 6289097733 |
| Address | 43/14/7/A PRAVASNAGAR PURBAPARA SERAMPORE 712249 | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||