Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01725 | Date 28/02/2019 |
| Token No | SM/18-19/5910 26/08/2019 | Serial | 038 |
| Patient Name | Mrs. PRIYANKA RAM | Contact No | 9038704364 |
| Address | 17/1/12 CHOWDHURY PARA LANE | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||