Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 08174 | Date 09/11/2024 |
| Token No | SM/24-25/30883 11/11/2024 | Serial | 028 |
| Patient Name | Miss ARPITA BAG | Contact No | 6291517368 |
| Address | 69/C J N LAHIRI ROAD KATAPOL KALITALA SERAMPORE 712201 | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||