Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00670 | Date 06/01/2020 |
| Token No | SM/19-20/3084 14/03/2020 | Serial | 021 |
| Patient Name | Miss NAISA KHATUN | Contact No | 7278549789 |
| Address | 14 TARAPUKUR LANE SERAMPORE MALLICKPARA | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||