Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03285 | Date 24/10/2019 |
| Token No | SM/24-25/19972 29/11/2024 | Serial | 002 |
| Patient Name | Mr. RAJU NAYAK | Contact No | NOT GIVEN |
| Address | J N LAHIRI ROAD | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||