Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02684 | Date 12/09/2022 |
| Token No | SM/22-23/2653 12/09/2022 | Serial | 006 |
| Patient Name | Mrs. RUMA BIBI | Contact No | 7439998764 |
| Address | 23/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 19 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||