Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02591 | Date 24/07/2019 |
| Token No | SM/19-20/8994 12/10/2020 | Serial | 006 |
| Patient Name | Mrs. KALPANA SINGH | Contact No | 8961138718 |
| Address | 45 AKHRABATI LANE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||