Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00362 | Date 13/08/2018 |
| Token No | SM/18-19/3228 12/04/2019 | Serial | 021 |
| Patient Name | Mr. PIR MAHAMMAD | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 60 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||