Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05268 | Date 10/01/2022 |
| Token No | SM/21-22/1878 11/01/2022 | Serial | 025 |
| Patient Name | Mr. SANTOSH SAH.... | Contact No | 7980936744 |
| Address | 6 RAM SITA LANE | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||