Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 16342 | Date 04/12/2025 |
| Token No | SM/25-26/8647 06/12/2025 | Serial | 044 Last Visit: 08/12/2025 |
| Patient Name | Mrs. SOMA GOPE | Contact No | |
| Address | 19 L B S ROAD SERAMPORE | Age | 42 Years,11 Months,6 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||