Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05438 | Date 16/02/2022 |
| Token No | SM/21-22/2174 16/02/2022 | Serial | 019 |
| Patient Name | Mrs. RUBY NAYAK | Contact No | 8777459801 |
| Address | J N LAHIRI ROAD | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||