Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01907 | Date 09/04/2019 |
| Token No | SM/18-19/3203 11/04/2019 | Serial | 025 |
| Patient Name | Mrs. DAYAWATI TANTI | Contact No | 8013418958 |
| Address | DEY ST | Age | 61 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||