Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07597 | Date 11/11/2022 |
| Token No | SM/22-23/6296 14/11/2022 | Serial | 049 |
| Patient Name | Mrs. RUPALI NAYEK. | Contact No | 8678831940 |
| Address | JITEN LAHIRI ROAD | Age | 42 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||