Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09723 | Date 21/07/2023 |
| Token No | SM/22-23/11102 21/07/2023 | Serial | 005 |
| Patient Name | Mrs. MADHUBATI PRADHAN | Contact No | NOT GIVEN |
| Address | 6 NO LINE, INDIA JUTE MILL | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||