Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09855 | Date 01/09/2025 |
| Token No | SM/25-26/7430 04/09/2025 | Serial | 002 |
| Patient Name | Mrs. AYESHA BEGAM | Contact No | 9007265070 |
| Address | BHADUA PUKURPARA RISHRA MOLLABER 712250 | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||