Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03983 | Date 14/07/2020 |
| Token No | SM/19-20/8903 22/09/2020 | Serial | 014 |
| Patient Name | Mr. UDIYO NAYAK | Contact No | 8420928792 |
| Address | J N LAHIRI ROAD | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||