Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03750 | Date 17/01/2020 |
| Token No | SM/19-20/8444 20/01/2020 | Serial | 008 |
| Patient Name | Mr. BISWAJIT BARADA | Contact No | 8013475647 |
| Address | 33/A K D B LANE | Age | 25 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||