Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04274 | Date 06/06/2023 |
| Token No | SM/22-23/12658 04/09/2023 | Serial | 008 |
| Patient Name | Mrs. NAMITA DOLUI | Contact No | |
| Address | CHTARA GODAR BAGAN BYE LANE SERAMPORE M 712201 | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||