Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02198 | Date 06/06/2019 |
| Token No | SM/18-19/4753 11/07/2019 | Serial | 034 |
| Patient Name | Mrs. MATESWARI DEBI | Contact No | 9836078533 |
| Address | PACHU BABUR BAZAR | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||