Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04160 | Date 17/03/2021 |
| Token No | SM/22-23/9422 06/05/2023 | Serial | 001 |
| Patient Name | Mrs. MALATI PARUI | Contact No | |
| Address | Age | 47 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||