Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05609 | Date 31/03/2022 |
| Token No | SM/22-23/7723 07/02/2023 | Serial | 018 |
| Patient Name | Mrs. DAMAYANTI BISWAL | Contact No | 7439388675 |
| Address | 7/282 RAM SITA LINE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||