Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03637 | Date 18/12/2019 |
| Token No | SM/22-23/7599 31/01/2023 | Serial | 046 |
| Patient Name | Mrs. DOLI BEGUM.. | Contact No | |
| Address | Age | 50 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||