Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03714 | Date 08/01/2020 |
| Token No | SM/19-20/8335 10/01/2020 | Serial | 013 |
| Patient Name | Miss PRIYA KUMARI | Contact No | 7980013630 |
| Address | DEY BARI | Age | 19 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||