Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10242 | Date 31/08/2023 |
| Token No | SM/22-23/12150 31/08/2023 | Serial | 028 |
| Patient Name | Mr. MD SAMSAD | Contact No | 8100813115 |
| Address | Age | 31 YRS Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||