Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12294 | Date 04/11/2024 |
| Token No | SM/24-25/19557 04/11/2024 | Serial | 003 |
| Patient Name | Mrs. JANAKI BARIK | Contact No | NOT GIVEN |
| Address | 19 DOSTI LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||