Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04802 | Date 26/08/2021 |
| Token No | SM/21-22/945 26/08/2021 | Serial | 010 |
| Patient Name | Mrs. SARASWATI PARIDA | Contact No | 9830599085 |
| Address | 136/A THAKURBATI STREET | Age | 32 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||