Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08098 | Date 24/10/2024 |
| Token No | SM/24-25/30112 26/10/2024 | Serial | 004 |
| Patient Name | Mrs. TOTA BEGAM | Contact No | 9903531152 |
| Address | 88/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||