Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05984 | Date 31/05/2022 |
| Token No | SM/22-23/3188 31/05/2022 | Serial | 008 |
| Patient Name | Mrs. MAMANI SWAIN | Contact No | 6372141603 |
| Address | INDIA JUTE MILL | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||