Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02091 | Date 20/05/2019 |
| Token No | SM/18-19/3945 03/06/2019 | Serial | 034 |
| Patient Name | Mr. SK. KABIR ALI | Contact No | 7449643523 |
| Address | 21/A K.C BHATTACHARYA ST | Age | 18 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||