Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10172 | Date 28/08/2023 |
| Token No | SM/22-23/12098 29/08/2023 | Serial | 031 |
| Patient Name | Miss KHALIKUL NESA | Contact No | |
| Address | DEY STREET | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||