Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04697 | Date 03/08/2023 |
| Token No | SM/25-26/11715 09/12/2025 | Serial | 012 |
| Patient Name | Mrs. AJMIRA BIBI | Contact No | 9883119707 |
| Address | 18 MIYAJAN DARJI LANE SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||