Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10721 | Date 25/02/2022 |
| Token No | SM/21-22/10350 28/02/2022 | Serial | 056 Last Visit: 24/05/2025 |
| Patient Name | Mrs. GULAFSA KHATUN | Contact No | 7439481530 |
| Address | 21/C CHATRA MUSALMAN PARA BYLANE SERAMPORE | Age | 30 Years,6 Months,21 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||