Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01029 | Date 20/02/2020 |
| Token No | SM/19-20/2507 24/02/2020 | Serial | 012 |
| Patient Name | Mrs. SHANTI BHUIYAN | Contact No | |
| Address | PRABASHNAGAR | Age | 60 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||