Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03106 | Date 23/09/2019 |
| Token No | SM/24-25/20232 16/12/2024 | Serial | 027 |
| Patient Name | Mrs. BELA PARIDA | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||