Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04188 | Date 23/03/2021 |
| Token No | SM/20-21/9195 23/03/2021 | Serial | 010 |
| Patient Name | Mrs. BINDU KOSTA | Contact No | 9883695870 |
| Address | BANGA LAXMI COTTON MILL | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||