Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08418 | Date 24/06/2020 |
| Token No | SM/19-20/23355 24/06/2020 | Serial | 027 Last Visit: 24/06/2020 |
| Patient Name | Mrs. UMA MODAK | Contact No | |
| Address | MAHESH | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||