Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03385 | Date 15/11/2019 |
| Token No | SM/18-19/7489 18/11/2019 | Serial | 031 |
| Patient Name | Mrs. BASANTI PRAJAPATI | Contact No | 7980009059 |
| Address | 55 RAILAND ROAD | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||