Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07878 | Date 05/12/2022 |
| Token No | SM/22-23/6846 06/12/2022 | Serial | 023 |
| Patient Name | Miss RITIMA NAYEK | Contact No | 6290607151 |
| Address | SHEORAFULI | Age | 22 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||