Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04947 | Date 28/09/2021 |
| Token No | SM/21-22/1194 28/09/2021 | Serial | 006 |
| Patient Name | Master TATHAGATA PARIDA | Contact No | 9830599085 |
| Address | 173 THAKUR BATI STREET | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||