Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00039 | Date 03/08/2018 |
| Token No | SM/24-25/15972 25/04/2024 | Serial | 010 |
| Patient Name | Mrs. JAYANTI PRADHAN | Contact No | 7595883317 |
| Address | 13 DEY STREET | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||