Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 03133 | Date 27/09/2019 |
| Token No | SM/18-19/6744 27/09/2019 | Serial | 018 |
| Patient Name | Mrs. AYESHA KHATUN | Contact No | NOT GIVEN |
| Address | TIN BAZAR | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||