Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02394 | Date 02/07/2019 |
| Token No | SM/18-19/5382 03/08/2019 | Serial | 009 |
| Patient Name | Mr. SK KALUA.. | Contact No | NOT GIVEN |
| Address | K M SHA STREET | Age | 50 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||