Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01790 | Date 13/03/2019 |
| Token No | SM/18-19/6352 11/09/2019 | Serial | 022 |
| Patient Name | Mrs. SUNITA PRASAD | Contact No | 7003608069 |
| Address | 3 DEY GHAT LANE | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||