Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01625 | Date 07/02/2019 |
| Token No | SM/18-19/3452 29/04/2019 | Serial | 026 |
| Patient Name | Mrs. SAIRA BANU | Contact No | 9088025000 |
| Address | A K C BHATTACHARYA STREET | Age | 48 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||