Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03298 | Date 25/10/2019 |
| Token No | SM/19-20/9080 03/12/2020 | Serial | 001 |
| Patient Name | Mrs. ROKEYA BEGUM | Contact No | 6290367837 |
| Address | 13 K C BHATTACHARJEE ST | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||