Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08112 | Date 04/01/2023 |
| Token No | SM/22-23/7373 05/01/2023 | Serial | 008 |
| Patient Name | Mrs. SABITA BRAMHA | Contact No | 9123903953 |
| Address | 10 DEY STREET | Age | 60 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||