Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05130 | Date 02/12/2021 |
| Token No | SM/22-23/5429 11/10/2022 | Serial | 029 |
| Patient Name | Mrs. GULSHAN ARA | Contact No | 9403019283 |
| Address | 10 CHATTERJEE LANE | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||