Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06928 | Date 06/09/2022 |
| Token No | SM/22-23/5014 08/09/2022 | Serial | 033 |
| Patient Name | Mrs. JHUMA SAHA | Contact No | 9748383340 |
| Address | 44/C/2/1 SADGOPE PARA | Age | 39 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||