Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01646 | Date 12/02/2019 |
| Token No | SM/19-20/8171 30/12/2019 | Serial | 010 |
| Patient Name | Mrs. FARIDA BIBI | Contact No | 9836716354 |
| Address | 23 K.C BHATTACHARYA ST | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||