Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02443 | Date 09/07/2019 |
| Token No | SM/18-19/6728 27/09/2019 | Serial | 002 |
| Patient Name | Mr. SANTOSH SAH | Contact No | 9339646969 |
| Address | 6 RAM SITA LANE | Age | 39 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||