Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07850 | Date 30/11/2022 |
| Token No | SM/25-26/674 05/06/2025 | Serial | 014 |
| Patient Name | Mr. MAHENDRA SAHU | Contact No | 9831332977 |
| Address | 48/12 BHAGIRATHI LANE | Age | 65 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||