Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09556 | Date 30/04/2021 |
| Token No | SM/21-22/2133 10/06/2021 | Serial | 040 Last Visit: 11/12/2025 |
| Patient Name | Mrs. DIL SHAD BANO | Contact No | 9123612310 |
| Address | CHATRA MUSHAL MAN PARA SERAMPORE | Age | 33 Years,11 Months,9 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||