Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03757 | Date 15/02/2023 |
| Token No | SM/22-23/6787 15/02/2023 | Serial | 006 |
| Patient Name | Mrs. MOMENA BIBI | Contact No | 8927748425 |
| Address | BHOLADANGA GAYESHPUR NADIA | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||