Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02306 | Date 18/06/2019 |
| Token No | SM/18-19/4391 24/06/2019 | Serial | 021 |
| Patient Name | Mrs. SANJU LATA BISWAL... | Contact No | 8697088466 |
| Address | 10 K.D.B LANE,DOSTI LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||