Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06378 | Date 19/07/2022 |
| Token No | SM/22-23/11479 08/08/2023 | Serial | 037 |
| Patient Name | Mrs. SHILA JAISWARA | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||