Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01562 | Date 10/01/2019 |
| Token No | SM/18-19/7492 18/11/2019 | Serial | 034 |
| Patient Name | Mr. SK. RAMJAN | Contact No | |
| Address | JOLKOL WARKER | Age | 19 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||