Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08997 | Date 10/05/2023 |
| Token No | SM/22-23/9511 11/05/2023 | Serial | 036 |
| Patient Name | Mrs. FARIDA KHATUN | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||