Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02079 | Date 17/05/2019 |
| Token No | SM/18-19/3793 24/05/2019 | Serial | 016 |
| Patient Name | Mr. SINGHASON MAHATO | Contact No | NOT GIVEN |
| Address | 19 DOSTI LANE | Age | 65 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||