Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 01144 | Date 12/10/2018 |
| Token No | SM/18-19/3511 02/05/2019 | Serial | 020 |
| Patient Name | Mrs. NURJAHAN BEGUM | Contact No | |
| Address | 22 lbs road | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||