Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08531 | Date 13/03/2023 |
| Token No | SM/22-23/9888 30/05/2023 | Serial | 011 |
| Patient Name | Mrs. DEBANKITA BISWAS | Contact No | 7980843042 |
| Address | 22 PATUA PARA LANE | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||