Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07501 | Date 03/11/2022 |
| Token No | SM/25-26/852 16/06/2025 | Serial | 017 |
| Patient Name | Miss RITIKA NAYEK | Contact No | 8961721072 |
| Address | J N LAHIRI ROAD | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||