Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08202 | Date 31/01/2023 |
| Token No | SM/24-25/16856 13/06/2024 | Serial | 005 |
| Patient Name | Mrs. PURNIMA KOIRI | Contact No | 6290264859 |
| Address | 79 DEY STREET | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||