Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02473 | Date 15/07/2019 |
| Token No | SM/18-19/7065 21/10/2019 | Serial | 032 |
| Patient Name | Mrs. BHAGYAWATI BISWAL | Contact No | 9330032624 |
| Address | INDIA JUTE MILL | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||