Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06450 | Date 22/07/2022 |
| Token No | SM/22-23/3992 22/07/2022 | Serial | 031 |
| Patient Name | Miss RIYA PARUI | Contact No | 9831783322 |
| Address | NALIKUL | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||