Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09319 | Date 13/06/2023 |
| Token No | SM/22-23/10141 13/06/2023 | Serial | 003 |
| Patient Name | Mrs. SARAJINI BISWAL | Contact No | 9062569009 |
| Address | 44A N L BHATTACHARJEE STREET | Age | 35 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||