Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09445 | Date 21/06/2023 |
| Token No | SM/22-23/10387 21/06/2023 | Serial | 033 |
| Patient Name | Mrs. BRINDA BISWAL | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||