Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04166 | Date 12/05/2023 |
| Token No | SM/22-23/8755 12/05/2023 | Serial | 002 |
| Patient Name | Mrs. SHIVANI SHARMA | Contact No | 9163827482 |
| Address | 9/489 MAHESH JAN-NAGAR ROAD PROVASNAGAR SERAMPORE 712249 | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||