Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02093 | Date 20/05/2019 |
| Token No | SM/18-19/3794 24/05/2019 | Serial | 017 |
| Patient Name | Mr. CHANDRABHAN PRAJAPATI. | Contact No | 9836078533 |
| Address | 6A BARA BAGAN | Age | 70 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||