Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09794 | Date 27/07/2023 |
| Token No | SM/22-23/11225 27/07/2023 | Serial | 010 |
| Patient Name | Mrs. PARBATI POLAI | Contact No | 8961611285 |
| Address | 8 COCKREN ROAD | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||