Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08508 | Date 03/03/2023 |
| Token No | SM/22-23/8192 04/03/2023 | Serial | 002 |
| Patient Name | Mrs. MINA DEBI | Contact No | 6291285934 |
| Address | 6 RAM SITA LANE | Age | 35 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||