Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09439 | Date 21/06/2023 |
| Token No | SM/22-23/10379 21/06/2023 | Serial | 025 |
| Patient Name | Mr. PANKAJ PARIDA | Contact No | NOT GIVEN |
| Address | 12 K.C BHATTACHARYA STREET | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||