Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03934 | Date 15/03/2023 |
| Token No | SM/22-23/7555 15/03/2023 | Serial | 002 |
| Patient Name | Mrs. MUSLIMA KHATUN | Contact No | 7679369932 |
| Address | BHOLADANGA MAJHERPARA SANTIPUR | Age | 21 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||