Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02678 | Date 01/08/2019 |
| Token No | SM/19-20/8412 17/01/2020 | Serial | 003 |
| Patient Name | Mr. SK BASIRUDDIN | Contact No | NOT GIVEN |
| Address | K C BHATTACHARJEE STREET | Age | 59 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||