Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09684 | Date 19/07/2023 |
| Token No | SM/22-23/11017 19/07/2023 | Serial | 008 |
| Patient Name | Mrs. BASANTI BISWAL | Contact No | 7569857595 |
| Address | RAM SITA LANE | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||