Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07320 | Date 18/10/2022 |
| Token No | SM/22-23/5645 18/10/2022 | Serial | 030 |
| Patient Name | Mrs. RAMAWANTI PARIDA | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 68 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||