Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05414 | Date 11/02/2022 |
| Token No | SM/22-23/3928 20/07/2022 | Serial | 012 |
| Patient Name | Mrs. PROVATI PATHAK | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 75 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||