Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02225 | Date 10/06/2019 |
| Token No | SM/21-22/107 20/04/2021 | Serial | 001 |
| Patient Name | Mrs. KAJAL NATH | Contact No | 8240001865 |
| Address | 42 G T ROAD | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||