Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05806 | Date 07/05/2022 |
| Token No | SM/22-23/2907 07/05/2022 | Serial | 003 |
| Patient Name | Mr. BABLU BISWAS | Contact No | 9679618132 |
| Address | DEY STREET | Age | 27 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||