Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05930 | Date 24/05/2022 |
| Token No | SM/22-23/3095 24/05/2022 | Serial | 034 |
| Patient Name | Miss RACHNA BARIK | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||