Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02054 | Date 13/05/2019 |
| Token No | SM/18-19/3906 31/05/2019 | Serial | 025 |
| Patient Name | Mrs. BANDANA SIL | Contact No | 7890299492 |
| Address | 18 DOSTI LANE | Age | 42 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||