Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02328 | Date 21/06/2019 |
| Token No | SM/18-19/4351 21/06/2019 | Serial | 019 |
| Patient Name | Mr. SRIMADRI PATTANAYAK | Contact No | 9051659033 |
| Address | 11 DOSTI LANE | Age | 69 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||