Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08983 | Date 10/05/2023 |
| Token No | SM/22-23/9442 10/05/2023 | Serial | 002 |
| Patient Name | Mrs. GOLAPI DALAI | Contact No | 8013672832 |
| Address | 7 NO LINE, INDIA JUTE MILL | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||