Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07377 | Date 22/10/2022 |
| Token No | SM/22-23/5836 26/10/2022 | Serial | 020 |
| Patient Name | Mrs. SUBHADRA NAYEK | Contact No | 6290691201 |
| Address | JUBLEE MODEL BOSTI, J.N. LAHIRI ROAD | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||