Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01215 | Date 17/03/2020 |
| Token No | SM/22-23/19357 04/03/2024 | Serial | 012 |
| Patient Name | Miss NEHA ADAK | Contact No | 9874341751 |
| Address | 65/25/10/E MAHESH JANNAGAR ROAD PRABASHNAGAR 712249 | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||