Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02534 | Date 22/07/2019 |
| Token No | SM/22-23/9352 03/05/2023 | Serial | 015 |
| Patient Name | Miss SUPRIYA BISWAL | Contact No | 9830606837 |
| Address | RAM SITA LANE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||