Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02599 | Date 01/09/2022 |
| Token No | SM/22-23/2404 01/09/2022 | Serial | 010 |
| Patient Name | Baby AFRIN MALLICK | Contact No | 8697916625 |
| Address | 28 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 4 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||