Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00227 | Date 25/08/2018 |
| Token No | SM/22-23/12351 08/09/2023 | Serial | 018 |
| Patient Name | Mrs. JAMUNA SWAIN | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||