Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04096 | Date 25/04/2023 |
| Token No | SM/22-23/8401 25/04/2023 | Serial | 027 |
| Patient Name | Mrs. MITA BISWAS | Contact No | 9674034832 |
| Address | PURBAPARA GHORAMARA SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||