Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05325 | Date 20/01/2022 |
| Token No | SM/21-22/1948 20/01/2022 | Serial | 002 |
| Patient Name | Mrs. SUNITA JENA | Contact No | 9875587532 |
| Address | 43/C NANILAL BHATTACHARJEE STREET | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||