Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04304 | Date 20/04/2021 |
| Token No | SM/21-22/118 20/04/2021 | Serial | 012 |
| Patient Name | Mrs. RADHA GIRI | Contact No | 8420335199 |
| Address | INDIA JUTE MILL | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||