Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05255 | Date 07/01/2022 |
| Token No | SM/22-23/14252 13/01/2024 | Serial | 003 |
| Patient Name | Mrs. BIDYADEBI JAISWARA | Contact No | NOT GIVEN |
| Address | 10 DEY GHAT LANE | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||