Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05519 | Date 09/03/2022 |
| Token No | SM/21-22/2417 14/03/2022 | Serial | 019 |
| Patient Name | Mrs. JAYSHREE TURIYA | Contact No | 6206051486 |
| Address | J N LAHIRI ROAD | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||