Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11007 | Date 03/01/2024 |
| Token No | SM/24-25/17033 20/06/2024 | Serial | 035 |
| Patient Name | Mrs. RATNA PRADHAN | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL LINE | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||