Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03940 | Date 15/03/2023 |
| Token No | SM/22-23/7568 15/03/2023 | Serial | 015 |
| Patient Name | Mrs. PRIYANKA PATRA | Contact No | 9635284013 |
| Address | MAYNA POTA KOLACHERA | Age | 29 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||