Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05569 | Date 22/03/2022 |
| Token No | SM/22-23/6822 05/12/2022 | Serial | 026 |
| Patient Name | Mrs. SONI DEVI | Contact No | 6290014255 |
| Address | 61 RAILAND ROAD | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||