Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09742 | Date 24/07/2023 |
| Token No | SM/22-23/11133 24/07/2023 | Serial | 005 |
| Patient Name | Mr. SANTOSH SWAIN | Contact No | 8961611285 |
| Address | RAM SITA LANE, 8 NO LINE | Age | 30 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||