Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03693 | Date 07/01/2020 |
| Token No | SM/19-20/8328 10/01/2020 | Serial | 006 |
| Patient Name | Mrs. LATA ROY | Contact No | 9432212515 |
| Address | B S N L OFFICE EMPLOYEE | Age | 51 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||