Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 00013 | Date 01/08/2018 |
| Token No | SM/18-19/6298 05/01/2019 | Serial | 013 Last Visit: 20/05/2025 |
| Patient Name | Mrs. MINA JAISWAL | Contact No | 9748688950 |
| Address | 15 KAPURIYA PATTI SERAMPORE(M) | Age | 40 Years,4 Months,17 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||