Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03234 | Date 19/10/2019 |
| Token No | SM/22-23/11855 22/08/2023 | Serial | 034 |
| Patient Name | Mrs. SARASWATI BARIK | Contact No | NOT GIVEN |
| Address | 9 NO LINE | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||