Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02208 | Date 07/06/2019 |
| Token No | SM/18-19/4403 24/06/2019 | Serial | 033 |
| Patient Name | Mrs. ROSIDA BEGUM | Contact No | 9339981191 |
| Address | 51/A NONILAL BHATTACHARYA ST | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||