Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02677 | Date 31/07/2019 |
| Token No | SM/18-19/5383 03/08/2019 | Serial | 010 |
| Patient Name | Mrs. RUBI NAYAK | Contact No | 8777459801 |
| Address | JITEN LAHIRI ROAD | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||