Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03727 | Date 13/01/2020 |
| Token No | SM/21-22/903 18/08/2021 | Serial | 019 |
| Patient Name | Mrs. SANDHYA APAT | Contact No | |
| Address | Age | 28 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||