Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05627 | Date 01/04/2022 |
| Token No | SM/22-23/2582 01/04/2022 | Serial | 003 |
| Patient Name | Mr. NARASINGH SAMAL | Contact No | 7595858443 |
| Address | 12 PITAMBAR DEY LANE | Age | 44 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||