Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02519 | Date 22/08/2022 |
| Token No | SM/22-23/3190 30/09/2022 | Serial | 007 |
| Patient Name | Miss CHHURAT ALI MOLLA | Contact No | 8910816626 |
| Address | 100/B HINDI SCHOOL PRABASHNAGAR SERAMPORE 712249 | Age | 38 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||