Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02862 | Date 21/08/2019 |
| Token No | SM/18-19/5869 24/08/2019 | Serial | 010 |
| Patient Name | Mrs. SUMAN DEBI | Contact No | 9007754737 |
| Address | 56 AKHRA BATI LANE | Age | 32 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||