Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01741 | Date 01/03/2019 |
| Token No | SM/18-19/2915 27/03/2019 | Serial | 001 |
| Patient Name | Mrs. HOSENARA BEGUM.. | Contact No | 9836134667 |
| Address | 19A K.C BHATTACHARYA ST | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||