Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02575 | Date 26/08/2022 |
| Token No | SM/22-23/2344 26/08/2022 | Serial | 039 |
| Patient Name | Mrs. SOMA SHIL | Contact No | |
| Address | PROVASNAGAR SERAMPORE 712249 | Age | 43 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||