Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 08573 | Date 17/03/2023 |
| Token No | SM/22-23/10217 15/06/2023 | Serial | 004 |
| Patient Name | Mr. RAMESH NAYEK | Contact No | 9007509958 |
| Address | JITEN LAHIRI ROAD | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||