Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01317 | Date 25/09/2018 |
| Token No | SM/18-19/2026 25/09/2018 | Serial | 008 Last Visit: 29/09/2018 |
| Patient Name | Mrs. LAXMI KHAN | Contact No | 9051324758 |
| Address | PRAVAS NAGAR | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||