Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01735 | Date 28/05/2022 |
| Token No | SM/22-23/202 28/05/2022 | Serial | 006 |
| Patient Name | Mrs. TETAR DEVI | Contact No | 8609060214 |
| Address | Age | 30 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||