Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10191 | Date 28/08/2023 |
| Token No | SM/22-23/12067 28/08/2023 | Serial | 069 |
| Patient Name | Mrs. SUSHAMA TIWARI | Contact No | |
| Address | 2NO BECHU DEY LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||