Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06464 | Date 25/07/2022 |
| Token No | SM/22-23/13727 13/12/2023 | Serial | 006 |
| Patient Name | Mrs. CHANDA SHAH | Contact No | 7980464213 |
| Address | 6/182 COCKRAIN ROAD | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||