Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05246 | Date 07/01/2022 |
| Token No | SM/21-22/1822 07/01/2022 | Serial | 003 |
| Patient Name | Mrs. BHARATI PARIDA | Contact No | 9830599085 |
| Address | THAKUR BATI STREET | Age | 68 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||