Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10785 | Date 16/11/2023 |
| Token No | SM/22-23/13313 16/11/2023 | Serial | 014 |
| Patient Name | Mrs. SAKUNTALA SAHU | Contact No | 9831107969 |
| Address | 18 NO LINE DHARMATALA | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||