Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09228 | Date 02/06/2023 |
| Token No | SM/22-23/10003 05/06/2023 | Serial | 050 |
| Patient Name | Mrs. BHAGYABATI PARIDA | Contact No | 9861046726 |
| Address | 113 R B SARANI | Age | 42 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||