Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02991 | Date 05/09/2019 |
| Token No | SM/18-19/6428 13/09/2019 | Serial | 032 |
| Patient Name | Mrs. PARUL DAS | Contact No | 8697122166 |
| Address | 32 DOSTY LANE | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||