Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02613 | Date 05/09/2022 |
| Token No | SM/25-26/4580 12/07/2025 | Serial | 001 |
| Patient Name | Mrs. TUSMINA KHATUN | Contact No | 8609060214 |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA | Age | 11 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||