Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03316 | Date 05/12/2022 |
| Token No | SM/25-26/6996 28/08/2025 | Serial | 005 |
| Patient Name | Mrs. RAMA DAS | Contact No | 8272981740 |
| Address | 9/A/1 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||