Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11661 | Date 14/06/2024 |
| Token No | SM/25-26/407 07/05/2025 | Serial | 029 |
| Patient Name | Mrs. SIMA DEBI | Contact No | 8420467719 |
| Address | RAM SITA LANE | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||