Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05324 | Date 20/01/2022 |
| Token No | SM/21-22/1978 21/01/2022 | Serial | 013 |
| Patient Name | Mr. SOVA HARI | Contact No | 6291298599 |
| Address | 44 PACHUGOPAL SARANI | Age | 19 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||