Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10960 | Date 25/04/2022 |
| Token No | SM/22-23/12401 12/05/2022 | Serial | 026 Last Visit: 02/05/2023 |
| Patient Name | Mrs. ROKSAR KHATUN | Contact No | 6291786731 |
| Address | BARABELU BELUMILIK CHATRA MUSALMAN PARABYE LANE SERAMPORE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||