Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04268 | Date 07/04/2021 |
| Token No | SM/22-23/14633 07/02/2024 | Serial | 020 |
| Patient Name | Mrs. ANJANA BISWAL | Contact No | NOT GIVEN |
| Address | 9 NO. LINE, INDIA JUTE MILL | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||