Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07647 | Date 14/11/2022 |
| Token No | SM/22-23/8715 05/04/2023 | Serial | 002 |
| Patient Name | Mr. PARASURAM SWAIN | Contact No | 9330761578 |
| Address | 12 PITAMBAR DEY LANE | Age | 51 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||