Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07619 | Date 12/11/2022 |
| Token No | SM/22-23/6235 12/11/2022 | Serial | 002 |
| Patient Name | Mr. NABIN PATTANAYAK | Contact No | 9831968557 |
| Address | 11 DOSTI LANE | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||