Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12774 | Date 12/03/2025 |
| Token No | SM/24-25/21308 12/03/2025 | Serial | 024 |
| Patient Name | Mrs. PRITI PARIDA | Contact No | 8100568025 |
| Address | 11 NO ACHARYA KC LANE | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||