Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12676 | Date 17/02/2025 |
| Token No | SM/24-25/21001 17/02/2025 | Serial | 021 |
| Patient Name | Mrs. SOUDAMINI BARIK | Contact No | 9836639360 |
| Address | 13/507 COCKRAIN ROAD | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||