Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07352 | Date 21/10/2022 |
| Token No | SM/22-23/5708 21/10/2022 | Serial | 008 |
| Patient Name | Mrs. RUPALI NAYEK | Contact No | 9123316243 |
| Address | JITEN LAHIRI ROAD | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||