Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06792 | Date 22/08/2022 |
| Token No | SM/25-26/2010 11/09/2025 | Serial | 005 |
| Patient Name | Mrs. NURJAHAN KHATUN | Contact No | 7439550466 |
| Address | 12 K. M BHATTACHARYA ST | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||