Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09877 | Date 03/09/2025 |
| Token No | SM/25-26/7433 04/09/2025 | Serial | 005 |
| Patient Name | Mrs. DALIYA BIBI | Contact No | 8479961939 |
| Address | 26/A MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||