Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02659 | Date 30/07/2019 |
| Token No | SM/19-20/7773 29/11/2019 | Serial | 036 |
| Patient Name | Mrs. ARUNA DAS | Contact No | 9903531379 |
| Address | R B SARANI | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||