Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04422 | Date 01/06/2021 |
| Token No | SM/21-22/317 01/06/2021 | Serial | 006 |
| Patient Name | Mrs. KABITA NAYEK | Contact No | 7980528191 |
| Address | J N LAHIRI ROAD | Age | 19 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||