Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06201 | Date 24/06/2022 |
| Token No | SM/22-23/3669 28/06/2022 | Serial | 046 |
| Patient Name | Mrs. RUBINA BEGUM. | Contact No | NOT GIVEN |
| Address | 49/A DR. N L BHATTACHARJEE STREET | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||