Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11722 | Date 29/06/2024 |
| Token No | SM/24-25/17251 01/07/2024 | Serial | 011 |
| Patient Name | Miss REBATI MUKHERJEE | Contact No | 6289550677 |
| Address | 13 DEY STREET | Age | 16 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||