Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03006 | Date 06/09/2019 |
| Token No | SM/18-19/6737 27/09/2019 | Serial | 011 |
| Patient Name | Mr. ARGHA PRATAB MANJHI | Contact No | 6369528925 |
| Address | 567 G T RAOD | Age | 44 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||