Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02241 | Date 15/07/2022 |
| Token No | SM/22-23/1366 15/07/2022 | Serial | 036 |
| Patient Name | Mrs. SARINA BIBI | Contact No | 6290102317 |
| Address | 9 MIYAJAN DARJI LANE MALLIKPARA SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||