Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06912 | Date 05/09/2022 |
| Token No | SM/22-23/4967 07/09/2022 | Serial | 015 |
| Patient Name | Mrs. SIKHA DAS | Contact No | 9163245488 |
| Address | 48/D KHASBAGAN LANE | Age | 46 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||