Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04264 | Date 07/04/2021 |
| Token No | SM/22-23/13011 11/10/2023 | Serial | 009 |
| Patient Name | Mrs. SUNAYNA JAISWARA | Contact No | NOT GIVEN |
| Address | 7 DEY GHAT LANE | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||