Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03712 | Date 08/01/2020 |
| Token No | SM/19-20/8336 10/01/2020 | Serial | 014 |
| Patient Name | Mr. BIKKI SINGH | Contact No | 7980013630 |
| Address | 90/C DEY STREET | Age | 26 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||