Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11794 | Date 16/07/2024 |
| Token No | SM/24-25/17541 16/07/2024 | Serial | 001 |
| Patient Name | Mrs. MANJU MAHANTY | Contact No | |
| Address | DEY STREET | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||