Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03566 | Date 06/12/2019 |
| Token No | SM/19-20/7904 06/12/2019 | Serial | 018 |
| Patient Name | Mr. MD. ARIF | Contact No | |
| Address | Age | 26 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||