Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06714 | Date 12/08/2022 |
| Token No | SM/22-23/4499 12/08/2022 | Serial | 008 |
| Patient Name | Mr. SUPRIYA LAIK | Contact No | 7008974878 |
| Address | 538 G T ROAD | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||