Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05946 | Date 26/05/2022 |
| Token No | SM/22-23/3126 26/05/2022 | Serial | 012 |
| Patient Name | Mrs. BILASHI NAYEK | Contact No | NOT GIVEN |
| Address | J. N. LAHIRI, JUBILI BASTI | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||