Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01845 | Date 29/03/2019 |
| Token No | SM/18-19/2982 29/03/2019 | Serial | 030 |
| Patient Name | Master PANKAJ SINGH | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 16 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||