Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06042 | Date 02/08/2019 |
| Token No | SM/19-20/8328 10/08/2019 | Serial | 049 Last Visit: 01/02/2022 |
| Patient Name | Mrs. RUKSANA KHATUN | Contact No | 9883633422 |
| Address | 19 T. C. GOSWAMI STREET | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||