Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01335 | Date 02/04/2020 |
| Token No | SM/22-23/1906 10/08/2022 | Serial | 004 |
| Patient Name | Mrs. NASINA BIBI | Contact No | |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA | Age | 57 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||