Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01683 | Date 25/05/2022 |
| Token No | SM/22-23/127 25/05/2022 | Serial | 039 |
| Patient Name | Mrs. TANUJA BIBI | Contact No | 7439707832 |
| Address | 33 MALLICKPARA LANE SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||