Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05851 | Date 17/05/2022 |
| Token No | SM/22-23/2985 17/05/2022 | Serial | 011 |
| Patient Name | Mrs. UMA TURI NAYEK | Contact No | 9339568821 |
| Address | J N LAHIRI ROAD, JUBILEE BASTI | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||