Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01344 | Date 06/12/2018 |
| Token No | SM/18-19/6294 06/09/2019 | Serial | 042 |
| Patient Name | Mrs. ANJU DEVI | Contact No | NOT GIVEN |
| Address | 10 DEY ST | Age | 48 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||