Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05661 | Date 05/04/2022 |
| Token No | SM/22-23/9619 17/05/2023 | Serial | 013 |
| Patient Name | Mr. GIRIDHARI PATRA | Contact No | NOT GIVEN |
| Address | 18 NO LINE, INDIA JUTE ILL | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||