Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05815 | Date 10/05/2022 |
| Token No | SM/22-23/9744 22/05/2023 | Serial | 022 |
| Patient Name | Mrs. RASHIDA BEGUM.... | Contact No | 8961406974 |
| Address | N L BHATTACHARJEE STREET | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||