Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07425 | Date 28/10/2022 |
| Token No | SM/22-23/5851 28/10/2022 | Serial | 002 |
| Patient Name | Mrs. KUNI SWAIN | Contact No | 7439330466 |
| Address | 14/B DEY STREET | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||