Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02285 | Date 20/07/2022 |
| Token No | SM/25-26/11711 09/12/2025 | Serial | 008 |
| Patient Name | Miss RUKSONA KHATUN | Contact No | 8481985945 |
| Address | 9 NO MALLICKPARA LANE SERAMPORE 712203 | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||