Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02340 | Date 04/12/2018 |
| Token No | SM/18-19/4683 05/12/2018 | Serial | 007 Last Visit: 06/12/2018 |
| Patient Name | Mrs. LAXMI PASWAN | Contact No | |
| Address | 10 M G ROAD | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||