Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01382 | Date 27/09/2018 |
| Token No | SM/18-19/2172 28/09/2018 | Serial | 001 Last Visit: 18/12/2025 |
| Patient Name | Mrs. ISHRAT JAHAN | Contact No | 9836760751 |
| Address | 21 CHATRA KUMAR PARA SERAMPORE | Age | 37 Years,11 Months,16 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||