Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03526 | Date 29/12/2022 |
| Token No | SM/22-23/5775 30/12/2022 | Serial | 007 |
| Patient Name | Mrs. ANOWARA BIBI | Contact No | 7980047145 |
| Address | 88/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||