Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03695 | Date 07/01/2020 |
| Token No | SM/21-22/2002 25/01/2022 | Serial | 011 |
| Patient Name | Mrs. NAYANTARA DOLUI | Contact No | 9748365969 |
| Address | BARA JHAKARI | Age | 65 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||