Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 02992 | Date 05/09/2019 |
| Token No | SM/18-19/6341 11/09/2019 | Serial | 011 |
| Patient Name | Mrs. NIRMALA BARADA | Contact No | 8013475647 |
| Address | DR KDB LANE | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||