Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02589 | Date 23/07/2019 |
| Token No | SM/18-19/5147 26/07/2019 | Serial | 026 |
| Patient Name | Mrs. SALEHA BEGUM | Contact No | 9836248271 |
| Address | 19/A K C BHATTACHARJEE STREET | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||