Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03167 | Date 09/10/2019 |
| Token No | SM/18-19/6863 10/10/2019 | Serial | 002 |
| Patient Name | Mr. SUMAN THANDAR | Contact No | 7044172043 |
| Address | 81/8 J N LAHIRI ROAD | Age | 14 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||