Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09442 | Date 12/06/2025 |
| Token No | SM/25-26/3453 13/06/2025 | Serial | 006 |
| Patient Name | Mrs. KALPANA SARKAR | Contact No | 7044495979 |
| Address | CHATRA SHITALATALA BAGER BAGAN 712202 | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||