Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04581 | Date 08/07/2021 |
| Token No | SM/21-22/576 08/07/2021 | Serial | 010 |
| Patient Name | Miss KRITTIKA BISWAL | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 3 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||