Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04078 | Date 19/10/2020 |
| Token No | SM/19-20/9025 19/10/2020 | Serial | 010 |
| Patient Name | Miss RAKHI BISWAS | Contact No | |
| Address | Age | 18 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||