Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 10845 | Date 30/11/2023 |
| Token No | SM/22-23/13452 30/11/2023 | Serial | 008 |
| Patient Name | Miss SRISTI NAYEK | Contact No | 8017961357 |
| Address | JUBILEE BASTI, JITEN LAHIRI ROAD | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||