Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03033 | Date 12/09/2019 |
| Token No | SM/18-19/6433 13/09/2019 | Serial | 037 |
| Patient Name | Mr. ASIT KUMAR DAS | Contact No | |
| Address | Age | 52 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||