Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01730 | Date 28/02/2019 |
| Token No | SM/18-19/2666 01/03/2019 | Serial | 025 |
| Patient Name | Mr. ARUN KUMAR SHAW | Contact No | 7003693465 |
| Address | 3 JODHAN SINGH ROAD | Age | 14 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||