Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02310 | Date 18/06/2019 |
| Token No | SM/18-19/4388 24/06/2019 | Serial | 018 |
| Patient Name | Miss SOMIYA SHIL.... | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 7 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||