Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00008 | Date 02/08/2018 |
| Token No | SM/18-19/5377 03/08/2019 | Serial | 004 |
| Patient Name | Mrs. BILLO METE | Contact No | 9674261549 |
| Address | A.B.GARDEN LANE | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||