Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01039 | Date 04/10/2018 |
| Token No | SM/18-19/6392 12/09/2019 | Serial | 039 |
| Patient Name | Mrs. RUMA DEBI | Contact No | 9836051566 |
| Address | 11 DOSTI LANE | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||