Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02738 | Date 06/08/2019 |
| Token No | SM/18-19/7554 20/11/2019 | Serial | 011 |
| Patient Name | Mrs. SABITA BISWAL | Contact No | 8820007828 |
| Address | PAL BAGAN DEY STREET | Age | 32 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||