Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06670 | Date 08/08/2022 |
| Token No | SM/22-23/4566 16/08/2022 | Serial | 041 |
| Patient Name | Mrs. SOMA MONDAL | Contact No | NOT GIVEN |
| Address | NAGA MORE, SERAMPORE | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||