Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09911 | Date 08/09/2025 |
| Token No | SM/25-26/7667 09/09/2025 | Serial | 007 |
| Patient Name | Mrs. DIPALI NAYAK | Contact No | 6290158816 |
| Address | BLOCK A B B GHOSH ROAD SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||