Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04924 | Date 24/09/2021 |
| Token No | SM/21-22/1157 24/09/2021 | Serial | 008 |
| Patient Name | Mrs. ANJALI PANDEY | Contact No | 9748748596 |
| Address | DHULIPARA | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||