Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02234 | Date 11/06/2019 |
| Token No | SM/18-19/4195 14/06/2019 | Serial | 053 |
| Patient Name | Miss LAXMI KHATUN | Contact No | 8981443008 |
| Address | 18 K.C BHATTACHARYA LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||