Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05194 | Date 21/09/2023 |
| Token No | SM/22-23/13349 21/09/2023 | Serial | 033 |
| Patient Name | Mrs. SUKLA DEY | Contact No | 8777728292 |
| Address | GHORAMARA P MALLIKPARA 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||