Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05052 | Date 16/11/2021 |
| Token No | SM/22-23/8708 04/04/2023 | Serial | 019 |
| Patient Name | Mrs. SARASWATI BARIK | Contact No | 9749521882 |
| Address | 13 NO LINE INDIA JUTE MILL | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||