Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02054 | Date 27/06/2022 |
| Token No | SM/22-23/2789 16/09/2022 | Serial | 008 |
| Patient Name | Mrs. LAKSHMI DAS | Contact No | 8017835395 |
| Address | 50 G T ROAD JHILBAGAN MALLICKPARA SERAMPORE 712203 | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||