Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11168 | Date 20/02/2024 |
| Token No | SM/22-23/14823 20/02/2024 | Serial | 032 |
| Patient Name | Mrs. NIRUPAMA SAHOO | Contact No | |
| Address | 48A/12 BHAGIRATHI LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||