Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09622 | Date 23/07/2025 |
| Token No | SM/25-26/6555 19/08/2025 | Serial | 014 |
| Patient Name | Miss SHUBHRA PRASAD | Contact No | 7439588478 |
| Address | B/77/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||