Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01850 | Date 02/04/2019 |
| Token No | SM/18-19/3080 04/04/2019 | Serial | 055 |
| Patient Name | Mrs. ANKITA TIWARI | Contact No | 9163175531 |
| Address | 76 DEY ST | Age | 21 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||