Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00791 | Date 22/01/2020 |
| Token No | SM/19-20/1791 24/01/2020 | Serial | 030 |
| Patient Name | Mrs. ASHA ADAK | Contact No | 7450957844 |
| Address | 65/25/10/E MAHESH JANNAGAR ROAD PRABASHNAGAR 712249 | Age | 36 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||