Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03636 | Date 18/12/2019 |
| Token No | SM/19-20/8128 18/12/2019 | Serial | 013 |
| Patient Name | Mrs. SWEETY SHAW.. | Contact No | |
| Address | Age | 21 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||