Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 10972 | Date 18/12/2023 |
| Token No | SM/24-25/16139 09/05/2024 | Serial | 038 |
| Patient Name | Mrs. BHAGYASHREE ROUT(MOHANTY) | Contact No | 8910378082 |
| Address | 20 A/1 SASHIBHUSAN GHOSH LANE | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||