Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00347 | Date 29/08/2018 |
| Token No | SM/18-19/6739 27/09/2019 | Serial | 013 |
| Patient Name | Mrs. MURALI DEVI | Contact No | NOT GIVEN |
| Address | 17/A/3 CHOWDHAURI PARA LANE | Age | 69 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||