Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09351 | Date 15/06/2023 |
| Token No | SM/22-23/10306 17/06/2023 | Serial | 002 |
| Patient Name | Miss NILU KIMARI | Contact No | 7549814490 |
| Address | 79 DEY STREET | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||