Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06426 | Date 21/07/2022 |
| Token No | SM/22-23/3955 21/07/2022 | Serial | 010 |
| Patient Name | Mrs. MOHANA SASMAL | Contact No | NOT GIVEN |
| Address | 102 MUKHERJEE PARA | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||