Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05317 | Date 18/01/2022 |
| Token No | SM/21-22/1962 20/01/2022 | Serial | 016 |
| Patient Name | Mr. DILIP SRIMANI | Contact No | 9051346190 |
| Address | 6 BECHU DEY LANE | Age | 53 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||