Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04571 | Date 07/07/2021 |
| Token No | SM/21-22/560 07/07/2021 | Serial | 002 |
| Patient Name | Mrs. ARATI DALAL | Contact No | 9339622493 |
| Address | NILMONI GHOSH LANE, MAHESH | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||