Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02215 | Date 10/06/2019 |
| Token No | SM/18-19/4389 24/06/2019 | Serial | 019 |
| Patient Name | Mrs. ROSUNA BIBI | Contact No | NOT GIVEN |
| Address | RAMPURHAT | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||