Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01985 | Date 26/04/2019 |
| Token No | SM/18-19/3517 02/05/2019 | Serial | 026 |
| Patient Name | Miss SNEHA JAISWARA | Contact No | NOT GIVEN |
| Address | 17 CHOWDHURY PARA | Age | 19 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||