Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04561 | Date 05/07/2021 |
| Token No | SM/21-22/545 05/07/2021 | Serial | 003 |
| Patient Name | Mrs. BINA KHATUN | Contact No | NOT GIVEN |
| Address | 15 K C BHATTACHARJEE STREET | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||