Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02356 | Date 27/06/2019 |
| Token No | SM/18-19/4531 28/06/2019 | Serial | 021 |
| Patient Name | Mr. NIRANJAN BISWAL | Contact No | 8981419490 |
| Address | 8 INDIA JUTE MILL | Age | 41 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||