Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03905 | Date 12/03/2020 |
| Token No | SM/19-20/8681 12/03/2020 | Serial | 006 |
| Patient Name | Miss SONIA KHATUN | Contact No | 9433887480 |
| Address | DHARMATALA | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||