Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03260 | Date 26/11/2022 |
| Token No | SM/25-26/5972 07/08/2025 | Serial | 017 |
| Patient Name | Mrs. MONOWARA BEGAM HALDER | Contact No | 8296499552 |
| Address | MALLICKPARA MALLICKPARA LANE DARGA SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 92 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||