Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04047 | Date 24/09/2020 |
| Token No | SM/19-20/8983 05/10/2020 | Serial | 003 |
| Patient Name | Mrs. PUJA SINGH | Contact No | 9831317746 |
| Address | B S N L OFFICE, SEY STREET | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||