Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04527 | Date 24/06/2021 |
| Token No | SM/21-22/1022 01/09/2021 | Serial | 008 |
| Patient Name | Mrs. MALY PAUL | Contact No | 8820433316 |
| Address | 57/G/A POMPA NAGAR, CHATRA | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||