Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03552 | Date 05/12/2019 |
| Token No | SM/19-20/7969 09/12/2019 | Serial | 042 |
| Patient Name | Mrs. ANTIMA GUPTA | Contact No | 8948488524 |
| Address | LAL BAHADUR SASTRI ROAD, JHAUTALA | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||