Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02057 | Date 27/06/2022 |
| Token No | SM/22-23/6782 15/02/2023 | Serial | 001 |
| Patient Name | Mrs. SALEMA BIBI | Contact No | 9007287580 |
| Address | 30/A MIYAJAN DARJI LANE SERAMPORE HOOGHLY 712203 | Age | 56 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||