Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07941 | Date 13/12/2022 |
| Token No | SM/22-23/6973 13/12/2022 | Serial | 029 |
| Patient Name | Mrs. TUMPA NAYEK | Contact No | 7439556179 |
| Address | JUBILEE BASTI | Age | 25 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||