Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10832 | Date 23/03/2022 |
| Token No | SM/22-23/11447 05/04/2022 | Serial | 055 Last Visit: 04/12/2025 |
| Patient Name | Mrs. MADHABI PATRA | Contact No | 7980681390 |
| Address | 42 KUMIR JALA ROAD | Age | 59 Years,11 Months,2 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||