Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05683 | Date 07/04/2022 |
| Token No | SM/22-23/4492 12/08/2022 | Serial | 001 |
| Patient Name | Master NIHAL PARIDA | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL, 9 NO LINE | Age | 2 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||