Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 11994 | Date 22/08/2024 |
| Token No | SM/24-25/18341 22/08/2024 | Serial | 010 |
| Patient Name | Mrs. MAYA NAYEK | Contact No | NOT GIVEN |
| Address | JITEN LAHIRI ROAD | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||