Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01051 | Date 24/02/2020 |
| Token No | SM/19-20/2649 27/02/2020 | Serial | 024 |
| Patient Name | Mrs. BANI ADAK | Contact No | 9804704328 |
| Address | 65/25/10/E MAHESH JANNAGAR ROAD PRABASHNAGAR 712249 | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||