Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08170 | Date 17/01/2023 |
| Token No | SM/22-23/7517 17/01/2023 | Serial | 022 |
| Patient Name | Mrs. SARMISHTHA MOHANTA | Contact No | 9432280445 |
| Address | 9 SADGOPE PARA MAHESH | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||