Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 08400 | Date 21/02/2023 |
| Token No | SM/22-23/7979 21/02/2023 | Serial | 004 |
| Patient Name | Miss PEYEL NAYEK | Contact No | 9474865061 |
| Address | 17 J N LAHIRI ROAD | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||