Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01806 | Date 13/03/2019 |
| Token No | SM/18-19/2847 13/03/2019 | Serial | 037 |
| Patient Name | Mrs. SHANTI DEBI | Contact No | |
| Address | india jutre mill | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||