Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10035 | Date 21/08/2023 |
| Token No | SM/22-23/13117 01/11/2023 | Serial | 004 |
| Patient Name | Mr. ASHOK SWAIN | Contact No | 9836218119 |
| Address | 12 NO. LINE, INDIA JUTE MILL | Age | 52 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||