Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09661 | Date 18/07/2023 |
| Token No | SM/22-23/14641 07/02/2024 | Serial | 028 |
| Patient Name | Mrs. SHARMILA DHARA | Contact No | NOT GIVEN |
| Address | 25 BANERJEE PARA | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||