Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05101 | Date 25/11/2021 |
| Token No | SM/24-25/16324 16/05/2024 | Serial | 043 |
| Patient Name | Mr. KARTIK PATRA | Contact No | NOT GIVEN |
| Address | 39 BHAGIRATHI LANE | Age | 54 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||