Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09155 | Date 23/05/2023 |
| Token No | SM/22-23/9825 26/05/2023 | Serial | 003 |
| Patient Name | Mrs. JUHI KHATUN | Contact No | 8101744627 |
| Address | 27 N L BHATTACHARJEE STREET | Age | 23 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||