Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04187 | Date 23/03/2021 |
| Token No | SM/20-21/9194 23/03/2021 | Serial | 009 |
| Patient Name | Mr. RAMSIA MAHATO | Contact No | |
| Address | 1 DEY GHAT LANE | Age | 51 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||