Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01218 | Date 17/03/2020 |
| Token No | SM/25-26/6362 14/08/2025 | Serial | 021 |
| Patient Name | Mrs. FATEMA BIBI | Contact No | 8481034399 |
| Address | 32 MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 150/80 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||