Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08958 | Date 03/05/2023 |
| Token No | SM/22-23/9353 03/05/2023 | Serial | 016 |
| Patient Name | Mrs. SUPRIYA BISWAL | Contact No | |
| Address | RAM SITA LANE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||