Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 11267 | Date 11/03/2024 |
| Token No | SM/22-23/15236 13/03/2024 | Serial | 019 |
| Patient Name | Mrs. SABITA NAYEK | Contact No | 801601603 |
| Address | J.N. LARI ROAD | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||