Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11282 | Date 14/03/2024 |
| Token No | SM/22-23/15308 17/03/2024 | Serial | 005 |
| Patient Name | Mrs. KABITA SASMAL | Contact No | 9903298513 |
| Address | 40/1 BHAGIRATHI LANE | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||