Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03672 | Date 03/01/2020 |
| Token No | SM/19-20/8232 06/01/2020 | Serial | 001 |
| Patient Name | Mr. MILITERY SINGH | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 71 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||