Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03486 | Date 28/11/2019 |
| Token No | SM/19-20/7789 29/11/2019 | Serial | 052 |
| Patient Name | Mrs. RUPALI SINGH | Contact No | 8777315397 |
| Address | NEAR B S N L OFFICE | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||