Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01097 | Date 28/02/2020 |
| Token No | SM/22-23/998 30/06/2022 | Serial | 012 |
| Patient Name | Mrs. HOSENARA BIBI | Contact No | 8697447524 |
| Address | 83 MALLIKPARA LANE SERAMPORE 712203 | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||