Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01875 | Date 10/06/2022 |
| Token No | SM/22-23/1857 04/08/2022 | Serial | 013 |
| Patient Name | Mrs. MIRA DEVI SARKAR | Contact No | 8777868648 |
| Address | 24H FIRINGI DANGA ROAD MALLICKPARA SERAMPORE 712203 | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||