Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10440 | Date 21/09/2023 |
| Token No | SM/22-23/15006 29/02/2024 | Serial | 003 |
| Patient Name | Mrs. SUNITA SWAIN | Contact No | 8582894853 |
| Address | 12 PITAMBAR DEY LANE | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||