Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07353 | Date 21/10/2022 |
| Token No | SM/22-23/5784 25/10/2022 | Serial | 012 |
| Patient Name | Mrs. SASMITA NAYEK | Contact No | 9123316243 |
| Address | JUBILEE MODEL BASTI, J N LAHIRI ROAD | Age | 16 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||