Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05153 | Date 14/12/2021 |
| Token No | SM/21-22/1657 17/12/2021 | Serial | 002 |
| Patient Name | Mr. BHARAT PRASAD | Contact No | 9433128197 |
| Address | 3 DEY GHAT LANE | Age | 54 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||