Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05184 | Date 22/12/2021 |
| Token No | SM/21-22/1706 22/12/2021 | Serial | 006 |
| Patient Name | Miss SWAPNA BISWAL | Contact No | 6289801605 |
| Address | 569 COCKRAIN ROAD | Age | 19 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||