Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03337 | Date 07/11/2019 |
| Token No | SM/22-23/13934 20/12/2023 | Serial | 011 |
| Patient Name | Mrs. AVA SASMAL | Contact No | 9331042874 |
| Address | 316/C G T ROAD, MAHESH | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||