Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01701 | Date 21/02/2019 |
| Token No | SM/18-19/2587 22/02/2019 | Serial | 030 |
| Patient Name | Mr. SANJIB SINGH | Contact No | 8420920103 |
| Address | 17 LENIN SARANI MALLICKPARA | Age | 31 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||