Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02901 | Date 27/08/2019 |
| Token No | SM/18-19/6086 30/08/2019 | Serial | 069 |
| Patient Name | Mr. RAMU SHAW | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 30 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||