Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02216 | Date 13/07/2022 |
| Token No | SM/22-23/1310 14/07/2022 | Serial | 010 |
| Patient Name | Mrs. CHANDRANI SAHA | Contact No | 6291993085 |
| Address | 3/41 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||