Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 06291 | Date 06/07/2022 |
| Token No | SM/22-23/3792 07/07/2022 | Serial | 014 |
| Patient Name | Mrs. SUSHILA SINGH | Contact No | NOT GIVEN |
| Address | 15/A LIBRARY LANE | Age | 76 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||