Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02292 | Date 17/06/2019 |
| Token No | SM/18-19/4292 18/06/2019 | Serial | 011 |
| Patient Name | Mr. SANJOY MALIK | Contact No | 7980111849 |
| Address | 9 A.B GARDEN LANE | Age | 21 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||