Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00509 | Date 20/08/2018 |
| Token No | SM/18-19/774 06/09/2018 | Serial | 012 |
| Patient Name | Mr. GANAPATI PARIDA | Contact No | 9681660305 |
| Address | 9 INDIAN JUTE MILL | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | KG |
| Pulse Rate | 69 / min | Height | cm |
| Diagnosis | |||