Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 09652 | Date 17/07/2023 |
| Token No | SM/22-23/10954 17/07/2023 | Serial | 037 |
| Patient Name | Miss SAINA NAYEK | Contact No | NOT GIVEN |
| Address | J N LAHIRI ROAD | Age | 6 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||