Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07665 | Date 15/11/2022 |
| Token No | SM/22-23/6319 15/11/2022 | Serial | 006 |
| Patient Name | Mrs. SAKUNTALA KOIRI | Contact No | 8902737949 |
| Address | 14 K D B LANE | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||