Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 11012 | Date 03/01/2024 |
| Token No | SM/24-25/16212 13/05/2024 | Serial | 018 |
| Patient Name | Mrs. RAJESWARI KOSTA | Contact No | 7003009241 |
| Address | 40 BLC MILL ROAD | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||