Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12884 | Date 17/04/2025 |
| Token No | SM/25-26/146 17/04/2025 | Serial | 007 |
| Patient Name | Mrs. TILAKA DAS,,,,,. | Contact No | |
| Address | Age | 74 YRS Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||