Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07999 | Date 21/12/2022 |
| Token No | SM/22-23/7098 21/12/2022 | Serial | 019 |
| Patient Name | Mr. KISHORE SWAIN | Contact No | NOT GIVEN |
| Address | 14B DEY STREET | Age | 16 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||