Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02203 | Date 13/07/2022 |
| Token No | SM/22-23/1262 13/07/2022 | Serial | 016 |
| Patient Name | Mrs. MALATI RAJBANSHI | Contact No | 7890046614 |
| Address | 4 NO COLONY SURER BAGAN DAKSHIN RAJYADHARPUR MALLICKPARA SERAMPORE 712203 | Age | 45 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||