Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02834 | Date 19/08/2019 |
| Token No | SM/18-19/6848 01/10/2019 | Serial | 038 |
| Patient Name | Mr. MANOJ KUMAR RAM | Contact No | NOT GIVEN |
| Address | 2 GOPAL GANGULY LANE | Age | 14 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||