Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02111 | Date 24/05/2019 |
| Token No | SM/21-22/1630 14/12/2021 | Serial | 021 |
| Patient Name | Mrs. G DEOKI | Contact No | 9874060636 |
| Address | 18 NO LINE INDIA JUTE MILL | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||