Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04048 | Date 24/09/2020 |
| Token No | SM/22-23/7311 02/01/2023 | Serial | 010 |
| Patient Name | Miss SNEHA BHARTI | Contact No | 7044759374 |
| Address | 1 DEY GHAT LANE | Age | 18 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||