Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00736 | Date 18/09/2018 |
| Token No | SM/18-19/2432 13/02/2019 | Serial | 002 |
| Patient Name | Mr. SHATRUGHNA SHA | Contact No | 9883205194 |
| Address | RAM SITA LANE | Age | 72 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||