Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03642 | Date 19/12/2019 |
| Token No | SM/20-21/9207 25/03/2021 | Serial | 006 |
| Patient Name | Mrs. BILLO METE | Contact No | |
| Address | Age | 42 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||