Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02873 | Date 22/08/2019 |
| Token No | SM/18-19/5905 26/08/2019 | Serial | 033 |
| Patient Name | Mr. SK SAFIUDDIN | Contact No | 9433576728 |
| Address | 11 K C BHATTACHARJEE STREET | Age | 63 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||