Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03408 | Date 18/11/2019 |
| Token No | SM/18-19/7548 20/11/2019 | Serial | 005 |
| Patient Name | Mrs. GITA PRASAD | Contact No | 9432444371 |
| Address | 10 DEY STREET | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||