Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00511 | Date 05/12/2019 |
| Token No | SM/22-23/13997 06/10/2023 | Serial | 002 |
| Patient Name | Mrs. SIDDIKA BEGAM | Contact No | 9231965453 |
| Address | 26/2 MIAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||