Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03271 | Date 22/10/2019 |
| Token No | SM/22-23/15450 27/03/2024 | Serial | 030 |
| Patient Name | Mrs. SUKANTI NAYEK | Contact No | 8981205883 |
| Address | J.N.LAHIRI ROAD | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||