Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01680 | Date 25/05/2022 |
| Token No | SM/22-23/3666 20/10/2022 | Serial | 032 |
| Patient Name | Mrs. RESHMA BIBI | Contact No | 7439998764 |
| Address | 23 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||