Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04057 | Date 17/04/2023 |
| Token No | SM/22-23/8293 18/04/2023 | Serial | 022 |
| Patient Name | Mrs. NILAM DEVI SRIVASTAV | Contact No | 8910773795 |
| Address | PURBAPARA GHORAMARA SERAMPORE 712203 | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||