Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05682 | Date 07/04/2022 |
| Token No | SM/22-23/2678 07/04/2022 | Serial | 007 |
| Patient Name | Mr. SHIBANI PARIDA | Contact No | 9038363989 |
| Address | 9 NO LINE, INDIA JUTE MILL | Age | 21 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||