Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03742 | Date 15/01/2020 |
| Token No | SM/22-23/15443 27/03/2024 | Serial | 023 |
| Patient Name | Mrs. KUNI SWAIN | Contact No | 6289672969 |
| Address | 8 NO LINE | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||