Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03510 | Date 29/11/2019 |
| Token No | SM/19-20/7823 02/12/2019 | Serial | 028 |
| Patient Name | Mr. PRAMOD KUMAR GUPTA | Contact No | 9681514462 |
| Address | 15 L B S ROAD | Age | 43 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||