Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12109 | Date 19/09/2024 |
| Token No | SM/24-25/18954 23/09/2024 | Serial | 033 |
| Patient Name | Mrs. SARASWATI KOIRI | Contact No | 8100299702 |
| Address | 79 DEY STREET | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||