Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08360 | Date 16/06/2020 |
| Token No | SM/20-21/26343 05/10/2020 | Serial | 079 Last Visit: 25/04/2022 |
| Patient Name | Mrs. ARCHANA ADAK | Contact No | |
| Address | UPHC-I | Age | 57 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||