Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07913 | Date 08/12/2022 |
| Token No | SM/22-23/8293 14/03/2023 | Serial | 029 |
| Patient Name | Mrs. MANASA DAS MALIK | Contact No | |
| Address | Age | 29 Y Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||