Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07108 | Date 22/09/2022 |
| Token No | SM/22-23/5303 24/09/2022 | Serial | 003 |
| Patient Name | Mrs. ASMA KHATUN | Contact No | 9051531746 |
| Address | 36 K.M. BHATTACHARYA STREET | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||