Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02752 | Date 22/09/2022 |
| Token No | SM/22-23/2928 22/09/2022 | Serial | 017 |
| Patient Name | Mrs. RIJIYA BIBI | Contact No | 8240104540 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 47 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||