Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02199 | Date 13/07/2022 |
| Token No | SM/22-23/1258 13/07/2022 | Serial | 012 |
| Patient Name | Mrs. ARJINA BIBI | Contact No | 7439166253 |
| Address | 23 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||