Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02228 | Date 11/06/2019 |
| Token No | SM/18-19/4194 14/06/2019 | Serial | 052 |
| Patient Name | Mrs. BINDU DEVI | Contact No | 9062253286 |
| Address | 9/467 INDIA JUTE MILL | Age | 60 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||