Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02343 | Date 24/06/2019 |
| Token No | SM/18-19/4409 24/06/2019 | Serial | 039 |
| Patient Name | Miss SOMIYA SHIL | Contact No | |
| Address | Age | 6 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||