Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02461 | Date 11/07/2019 |
| Token No | SM/18-19/6745 27/09/2019 | Serial | 019 |
| Patient Name | Mrs. ABEDA BEGUM | Contact No | 9163193133 |
| Address | 573 G T ROAD | Age | 65 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||