Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06215 | Date 27/06/2022 |
| Token No | SM/22-23/3662 28/06/2022 | Serial | 039 |
| Patient Name | Mrs. SUJATA NAYEK | Contact No | 9330603202 |
| Address | J N LAHIRI ROAD | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||