Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04853 | Date 01/09/2021 |
| Token No | SM/21-22/1562 07/12/2021 | Serial | 004 |
| Patient Name | Mrs. SARITA DEBI | Contact No | 6291966678 |
| Address | 126 R B SARANI | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||