Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02838 | Date 30/09/2022 |
| Token No | SM/22-23/5014 06/12/2022 | Serial | 012 |
| Patient Name | Miss PARMIN KHATUN | Contact No | 6289646310 |
| Address | 23/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||