Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06386 | Date 19/07/2022 |
| Token No | SM/22-23/4665 23/08/2022 | Serial | 018 |
| Patient Name | Mrs. SANTOSHI BEHARA | Contact No | 9836274539 |
| Address | 3 PARSHI LANE | Age | 27 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||