Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03183 | Date 14/10/2019 |
| Token No | SM/18-19/6908 14/10/2019 | Serial | 024 |
| Patient Name | Mrs. MANJULA PRADHAN | Contact No | 8100403813 |
| Address | INDIA JITE MILL 9 NO LINE | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||