Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 05826 | Date 12/05/2022 |
| Token No | SM/22-23/2972 13/05/2022 | Serial | 006 |
| Patient Name | Miss SWATI SHAW | Contact No | 9831345622 |
| Address | 97/F/5 PRAVASH NAGAR | Age | 15 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||