Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02513 | Date 19/07/2019 |
| Token No | SM/25-26/1018 30/06/2025 | Serial | 003 |
| Patient Name | Mrs. CHANDRABATI PRADHAN | Contact No | NOT GIVEN |
| Address | 8NO. LINE | Age | 59 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||