Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07503 | Date 03/11/2022 |
| Token No | SM/22-23/5995 03/11/2022 | Serial | 023 |
| Patient Name | Mrs. DIPIKA KHATUN | Contact No | NOT GIVEN |
| Address | TIN BAZAR | Age | 20 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||