Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07671 | Date 15/11/2022 |
| Token No | SM/22-23/6507 21/11/2022 | Serial | 047 |
| Patient Name | Miss SRISTI PATTANAYAK | Contact No | 7890198322 |
| Address | 11 DOSTI LANE | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||