Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05719 | Date 20/04/2022 |
| Token No | SM/22-23/3546 22/06/2022 | Serial | 009 |
| Patient Name | Mrs. SARIDA BEGUM | Contact No | NOT GIVEN |
| Address | BORA | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||