Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02655 | Date 07/09/2022 |
| Token No | SM/22-23/2598 09/09/2022 | Serial | 005 |
| Patient Name | Mrs. SUNITA HALDER | Contact No | 7890520295 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||