Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09050 | Date 15/05/2023 |
| Token No | SM/22-23/12314 07/09/2023 | Serial | 007 |
| Patient Name | Mrs. SUMITRA BARIK | Contact No | 7978814676 |
| Address | 18 NO LINE | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||