Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07558 | Date 09/11/2022 |
| Token No | SM/22-23/6180 10/11/2022 | Serial | 024 |
| Patient Name | Mrs. JHUMPA DAS | Contact No | 9123758304 |
| Address | 111 G.T. ROAD, MANIKTALA | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||