Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10231 | Date 31/08/2023 |
| Token No | SM/22-23/12133 31/08/2023 | Serial | 011 |
| Patient Name | Miss SHRUTI BARIK | Contact No | 6290867141 |
| Address | 13/503 INDIA JUTE MILL | Age | 21 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||