Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07397 | Date 08/07/2024 |
| Token No | SM/24-25/24695 09/07/2024 | Serial | 011 |
| Patient Name | Mr. SK JAKIR | Contact No | 8981442180 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||