Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02217 | Date 10/06/2019 |
| Token No | SM/18-19/4108 11/06/2019 | Serial | 039 |
| Patient Name | Mr. SHYAM NARAYAN PRASAD | Contact No | 8697470982 |
| Address | BORO BELU KOLTALA | Age | 66 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||