Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08553 | Date 15/03/2023 |
| Token No | SM/22-23/8302 15/03/2023 | Serial | 003 |
| Patient Name | Mr. MONORANJAN SWAIN | Contact No | 6290815892 |
| Address | 12 PITAMBAR DEY LANE | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||