Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03579 | Date 09/12/2019 |
| Token No | SM/19-20/8061 14/12/2019 | Serial | 016 |
| Patient Name | Mrs. SANJU DEBI | Contact No | NOT GIVEN |
| Address | 2 LAL BAHADUR SASTRI ROAD, TIN BAZAR | Age | 35 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||