Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01812 | Date 02/06/2022 |
| Token No | SM/22-23/4104 07/11/2022 | Serial | 003 |
| Patient Name | Mrs. SAMENA BIBI | Contact No | 9083651245 |
| Address | BHOLADANGA GAYESHPUR P | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||