Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09666 | Date 18/07/2023 |
| Token No | SM/22-23/10975 18/07/2023 | Serial | 009 |
| Patient Name | Mr. SAHADEB NAYEK | Contact No | 8100049918 |
| Address | J.N LAHIRI ROAD | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||