Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02986 | Date 04/09/2019 |
| Token No | SM/19-20/8071 16/12/2019 | Serial | 002 |
| Patient Name | Mr. BRIJESH KUMAR YADAV | Contact No | 9662217466 |
| Address | 11 DR KALIDAS BHATTACHARYA LANE | Age | 27 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||