Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05458 | Date 21/02/2022 |
| Token No | SM/21-22/2252 22/02/2022 | Serial | 024 |
| Patient Name | Mrs. MADHABI DAS | Contact No | 8334072879 |
| Address | 48/B KHASBAGAN | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||