Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05937 | Date 25/05/2022 |
| Token No | SM/22-23/3112 25/05/2022 | Serial | 001 |
| Patient Name | Mrs. ANNOPURNA GUPTA | Contact No | |
| Address | Age | 55 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||