Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02632 | Date 26/07/2019 |
| Token No | SM/18-19/5388 03/08/2019 | Serial | 015 |
| Patient Name | Mr. RABINDRANATH CHOWDHURY | Contact No | 9831318061 |
| Address | 467/A/1 GT ROAD | Age | 58 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||