Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08521 | Date 09/01/2025 |
| Token No | SM/24-25/33967 10/01/2025 | Serial | 003 |
| Patient Name | Mrs. DALI MOLLA | Contact No | 8017173759 |
| Address | 59/C MALLICKPARA LANE SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||