Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01559 | Date 08/01/2019 |
| Token No | SM/19-20/8507 28/01/2020 | Serial | 007 |
| Patient Name | Mrs. CHANDRABATI DEVI | Contact No | NOT GIVEN |
| Address | R.B SARANI | Age | 56 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||