Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07045 | Date 15/09/2022 |
| Token No | SM/22-23/5174 16/09/2022 | Serial | 017 |
| Patient Name | Mrs. RENU DEBI | Contact No | NOT GIVEN |
| Address | 113 R.B. SARANI | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||