Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03459 | Date 21/11/2019 |
| Token No | SM/25-26/6053 26/10/2026 | Serial | 003 |
| Patient Name | Mrs. DIMPLE JAISWARA | Contact No | 7605837780 |
| Address | 60 NO DEY GHAT LANE | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||