Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07319 | Date 18/10/2022 |
| Token No | SM/22-23/5644 18/10/2022 | Serial | 029 |
| Patient Name | Mrs. MANJU SWAIN | Contact No | NOT GIVEN |
| Address | 3 PITAMBAR DEY LANE | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||