Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02346 | Date 25/06/2019 |
| Token No | SM/18-19/4626 05/07/2019 | Serial | 034 |
| Patient Name | Mr. SOMNATH SWAIN | Contact No | 9748929428 |
| Address | 12 PITAMBAR DEY LANE | Age | 67 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||