Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09453 | Date 22/06/2023 |
| Token No | SM/22-23/10405 22/06/2023 | Serial | 007 |
| Patient Name | Miss PUNAM PARIDA | Contact No | NOT GIVEN |
| Address | 2 TELIPARA LANE | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||