Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00639 | Date 08/09/2018 |
| Token No | SM/19-20/8474 25/01/2020 | Serial | 001 |
| Patient Name | Mr. BHAGABAN JENNA | Contact No | 9038801477 |
| Address | 438/A INDIA JUTE MILL | Age | 45 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||