Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04248 | Date 06/04/2021 |
| Token No | SM/21-22/35 06/04/2021 | Serial | 012 |
| Patient Name | Mr. GANESH BHAR | Contact No | 8981432227 |
| Address | 56 DEY STREET | Age | 67 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||