Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09694 | Date 09/06/2021 |
| Token No | SM/21-22/2122 10/06/2021 | Serial | 029 Last Visit: 19/07/2021 |
| Patient Name | Mrs. SAHINA BEGUM | Contact No | 9874724702 |
| Address | CHATRA MUSHALMAN PARA SERAMPORE | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||