Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02147 | Date 30/05/2019 |
| Token No | SM/18-19/4684 08/07/2019 | Serial | 051 |
| Patient Name | Mrs. NITU DEVI | Contact No | 9662217466 |
| Address | DEY ST PALBAGAN | Age | 26 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||