Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04584 | Date 09/07/2021 |
| Token No | SM/21-22/583 09/07/2021 | Serial | 007 |
| Patient Name | Mr. JAGABATI NAYEK | Contact No | 9836903085 |
| Address | TIN BAZAR | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||