Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01100 | Date 09/10/2018 |
| Token No | SM/18-19/3230 12/04/2019 | Serial | 023 |
| Patient Name | Mr. SANJIB SINGH | Contact No | |
| Address | Age | 32 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||