Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09152 | Date 22/05/2023 |
| Token No | SM/22-23/9761 22/05/2023 | Serial | 039 |
| Patient Name | Mr. SUMAN PARIDA | Contact No | 9748589410 |
| Address | 9 NO LINE | Age | 36 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||