Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04456 | Date 08/06/2021 |
| Token No | SM/21-22/379 08/06/2021 | Serial | 009 |
| Patient Name | Mrs. SUMANTI PRADHAN | Contact No | 9836045661 |
| Address | 2 PANCHANAN TALA | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||