Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01884 | Date 05/04/2019 |
| Token No | SM/18-19/6283 06/09/2019 | Serial | 031 |
| Patient Name | Mrs. KRISHNA BENI SWAIN | Contact No | 9831132602 |
| Address | 15/A K.C LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||