Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04904 | Date 13/09/2021 |
| Token No | SM/21-22/1121 13/09/2021 | Serial | 010 |
| Patient Name | Mr. RABI VERMA | Contact No | |
| Address | Age | 31 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||