Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07347 | Date 21/10/2022 |
| Token No | SM/22-23/5703 21/10/2022 | Serial | 003 |
| Patient Name | Mrs. BABITA NAYEK | Contact No | 7439401580 |
| Address | 6 DOSTI LANE | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||