Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12480 | Date 20/12/2024 |
| Token No | SM/24-25/20304 20/12/2024 | Serial | 003 |
| Patient Name | Mrs. SANTOSHI BARIK | Contact No | 7439163691 |
| Address | DOSTI LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||