Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07679 | Date 15/11/2022 |
| Token No | SM/22-23/6432 18/11/2022 | Serial | 003 |
| Patient Name | Mrs. RADHA HARI | Contact No | NOT GIVEN |
| Address | 4 NO BARI, BESUAHATA, NEAR SERAMPORE THANA | Age | 35 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||