Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02908 | Date 17/10/2022 |
| Token No | SM/22-23/3501 17/10/2022 | Serial | 003 |
| Patient Name | Mrs. DOLENA BIBI | Contact No | 9123623261 |
| Address | 18 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||