Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11016 | Date 03/01/2024 |
| Token No | SM/24-25/19131 30/09/2024 | Serial | 055 |
| Patient Name | Mrs. SUJATA SAMANTA | Contact No | 9064036409 |
| Address | PANTAHARI, BALIPUR | Age | 46YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||