Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09804 | Date 25/08/2025 |
| Token No | SM/25-26/7237 01/09/2025 | Serial | 055 |
| Patient Name | Mrs. LAXMI SHAW | Contact No | 6290261311 |
| Address | 170/Y D BLOCK TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||