Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02342 | Date 29/07/2022 |
| Token No | SM/22-23/1690 29/07/2022 | Serial | 016 |
| Patient Name | Mrs. MASUMA KHATUN | Contact No | |
| Address | PROVASNAGAR SERAMPORE 712249 | Age | 18 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||