Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06365 | Date 19/07/2022 |
| Token No | SM/22-23/4458 10/08/2022 | Serial | 043 |
| Patient Name | Mrs. SABITRI SWAIN | Contact No | NOT GIVEN |
| Address | 14 B DEY ST | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||