Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09470 | Date 23/06/2023 |
| Token No | SM/22-23/10435 23/06/2023 | Serial | 005 |
| Patient Name | Mrs. ANITA SWAIN | Contact No | 8961611285 |
| Address | 7 NO LINE | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||