Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03646 | Date 26/12/2019 |
| Token No | SM/19-20/8158 27/12/2019 | Serial | 004 |
| Patient Name | Miss LAKHI BISWAL | Contact No | 9088473921 |
| Address | 6A DOSTI LANE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||