Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02219 | Date 10/06/2019 |
| Token No | SM/18-19/4631 05/07/2019 | Serial | 039 |
| Patient Name | Mr. INTIAZ KHAN | Contact No | 9681443236 |
| Address | 84 DEY ST | Age | 32 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||