Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02835 | Date 19/08/2019 |
| Token No | SM/18-19/5758 20/08/2019 | Serial | 026 |
| Patient Name | Mr. SWAPAN SINGH | Contact No | 8961138718 |
| Address | 49 AKHRA BATI LANE | Age | 40 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||