Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01044 | Date 04/10/2018 |
| Token No | SM/18-19/6012 29/08/2019 | Serial | 010 |
| Patient Name | Mrs. BABY ROY | Contact No | 9830644834 |
| Address | 18 PANCHANAN TALA LANE | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||