Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04343 | Date 28/04/2021 |
| Token No | SM/22-23/5010 08/09/2022 | Serial | 029 |
| Patient Name | Mrs. RINA SINHA | Contact No | 9874685748 |
| Address | 120 THAKUR BATI STREET | Age | 51 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||