Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06228 | Date 28/06/2022 |
| Token No | SM/22-23/3627 28/06/2022 | Serial | 004 |
| Patient Name | Mrs. PUJA HARIJAN | Contact No | NOT GIVEN |
| Address | J N LAHIRI ROAD | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||