Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04040 | Date 24/09/2020 |
| Token No | SM/19-20/8962 28/09/2020 | Serial | 012 |
| Patient Name | Mrs. PAYEL SINGH | Contact No | 9874408556 |
| Address | 52 DHULIPARA LANE | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||