Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01015 | Date 18/02/2020 |
| Token No | SM/22-23/5210 12/12/2022 | Serial | 021 |
| Patient Name | Mrs. SURAIYA KHATUN | Contact No | 9088072519 |
| Address | 7 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||