Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08561 | Date 16/01/2025 |
| Token No | SM/25-26/11055 27/11/2025 | Serial | 008 |
| Patient Name | Mrs. AFRINA SULTANA | Contact No | 9330635465 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||