Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02242 | Date 13/06/2019 |
| Token No | SM/19-20/8347 13/01/2020 | Serial | 003 |
| Patient Name | Mrs. KASHMIRA BIBI | Contact No | NOT GIVEN |
| Address | TIKIA PARA | Age | 43 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||