Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07306 | Date 18/10/2022 |
| Token No | SM/22-23/5695 19/10/2022 | Serial | 032 |
| Patient Name | Miss SIMI BAURI | Contact No | 9051310783 |
| Address | 543 G T ROAD | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||