Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03962 | Date 24/06/2020 |
| Token No | SM/22-23/4158 28/07/2022 | Serial | 020 |
| Patient Name | Mrs. SAROJINI BISWAL | Contact No | |
| Address | Age | 35 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||