Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06104 | Date 15/06/2022 |
| Token No | SM/22-23/3417 15/06/2022 | Serial | 011 |
| Patient Name | Mrs. SHITAL NAYAK | Contact No | 7980494208 |
| Address | JUBILI BASI, J N LAHIRI ROAD | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||