Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03065 | Date 07/11/2022 |
| Token No | SM/22-23/4105 07/11/2022 | Serial | 004 |
| Patient Name | Mrs. TASLIMA BEGAM | Contact No | 9007690825 |
| Address | 88/D MIYAJAN DARJEE LANE SERAMPORE | Age | 20 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||