Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02480 | Date 16/07/2019 |
| Token No | SM/18-19/4987 18/07/2019 | Serial | 013 |
| Patient Name | Mrs. BINA DEBI | Contact No | 9883326672 |
| Address | 9 DEY GHAT LANE | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||