Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06001 | Date 03/06/2022 |
| Token No | SM/22-23/3262 07/06/2022 | Serial | 028 |
| Patient Name | Mrs. JHILIK KHATUN | Contact No | 7074769378 |
| Address | 50 N L BHATTACHARJEE STREET | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||