Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12526 | Date 14/01/2025 |
| Token No | SM/25-26/737 10/06/2025 | Serial | 005 |
| Patient Name | Mrs. SABITA SAMAL | Contact No | 7595858443 |
| Address | DEY STREET DEY BARI | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||